Secular trends of candidemia in a tertiary care hospital

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• 作者：Thiago Zinsly Sampaio Camargo ; Alex ; re Rodrigues Marra ; Claudia Vallone Silva ; Maria Fatima Santos Cardoso ; Marina ; s Dalla Valle Martino ; Luis Fern ; o Aranha Camargo ; Luci Correa
• 关键词：Candidemia ; mortality ; antifungal use ; hospital-acquired infection
• 刊名：American Journal of Infection Control
• 出版年：2010
• 出版时间：September 2010
• 年：2010
• 卷：38
• 期：7
• 页码：546-551
• 全文大小：187 K

文摘

ass=""h4"">Background

Candidemias account for 8 % to 15 % of hospital-acquired bloodstream infections. They have been associated with previous exposure to antimicrobials and are considered high-morbidity infections with high treatment costs. This study characterizes candidemias in a tertiary care hospital and assesses their incidence rates, clinical and microbiological features, and use of antifungals.

ass=""h4"">Methods

We assessed hospital-acquired candidemias in the period from January 1997 to July 2007 in a high-complexity private hospital.

ass=""h4"">Results

There were 151 cases of candidemia in 147 patients. The incidence rate was 0.74 episodes/1000 admissions. The mean age of the patients was 60 years (standard deviation ± 24.9), and the mean length of hospital stay before the blood culture identified candidemia was 40.9 days (standard deviation ± 86.3). The in-hospital mortality rate was 44.2 % . C albicans was isolated in 44 % (n = 67) of the cases, and no difference in mortality rates was found between species (Candida albicans vs C non-albicans, P = .6). The average use of antifungals in the period was 104.0 defined daily dose/1000 patient-days.

ass=""h4"">Conclusion

We found a high mortality rate associated to candidemia events and an increasingly important role of Candida non-albicans. New approaches to health care-related infection control and to defining prophylactic and preemptive therapies should change this scenario in the future.