Candidemia at a tertiary-care hospital: epidemiology, treatment, clinical outcome and risk factors for death

Eur J Clin Microbiol Infect Dis. 2002 Nov;21(11):767-74. doi: 10.1007/s10096-002-0822-1. Epub 2002 Oct 31.

Abstract

The demographic, clinical and microbiological data of patients with candidemia at the "Hopital Universitario La Fe", a tertiary-care hospital in Valencia, Spain, from 1995 to 1997 was analyzed retrospectively. Candida spp. were isolated in blood cultures from 145 patients, 32% of whom were children (25% of these were neonates). The most common species isolated was Candida albicans, followed by Candida parapsilosis, Candida krusei and Candida tropicalis. Risk factors for candidemia included underlying disease, therapy with broad-spectrum antibiotics and the presence of a central venous catheter. The majority of children were treated with amphotericin B, whereas 52% of adults received fluconazole. Overall mortality was 44% (30% in children and 50% in adults), and attributable mortality was 30% (24% in children and 33% in adults). Multivariate analysis indicated that neutropenia, corticosteroid therapy, lack of antifungal treatment, and failure to replace the central venous catheter were factors associated with candidemia-related death. Among the adult population, an APACHE II score greater than 15 predicted candidemia-related death.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Antifungal Agents / therapeutic use*
  • Candida / classification*
  • Candida / isolation & purification
  • Candidiasis / diagnosis
  • Candidiasis / drug therapy*
  • Candidiasis / epidemiology*
  • Child
  • Child, Preschool
  • Female
  • Fungemia / diagnosis
  • Fungemia / drug therapy*
  • Fungemia / epidemiology*
  • Hospital Mortality / trends*
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Sex Distribution
  • Spain / epidemiology
  • Survival Analysis

Substances

  • Antifungal Agents