• 作者：M. Jesú ; s Rodrí ; guez-Hern&#225 ; ndez^a ; Maite Ruiz-Pé ; rez de Pipaon^a ; Manuel M&#225 ; rquez-Solero^b ; Patricia Martí ; n-Rico^c ; Juan José ; Castó ; n-Osorio^d ; Francisca M. Guerrero-S&#225 ; nchez^e ; Elisa Vidal-Verdú ; ^f ; Carolina Garcí ; a-Figueras^g ; Alfonso del Arco-Jimé ; nez^h ; Jesú ; s Rodrí ; guez-Bañ ; oⁱ ; Estrella Martí ; n-Mazuelos^j ; José ; Miguel Cisneros-Herreros^a ; ^{cisnerosjm@telefonica.net} ; por el Grupo de Investigadores de la Sociedad Andaluza de Microbiologí ; a y Parasitologí ; a (SAMPAC) y de la Sociedad Andaluza de Enfermedades Infecciosas (SAEI)¹
• 关键词：Candidemia ; Hospitales andaluces ; Epidemiologí ; a
• 刊名：Enfermedades Infecciosas y Microbiolog¨ªa Cl¨ªnica
• 出版年：2011
• 出版时间：May 2011
• 年：2011
• 卷：29
• 期：5
• 页码：328-333
• 全文大小：151 K

Introduction

Candidemia is a nosocomial infection with high associated mortality. There have been changes in microbiology, epidemiology and treatment over the last few years, which has led us to analyse our own situation.

Material and methods

Prospective, multicentre and observational study. All episodes of candidemia in adult patients seen in 17 Andalusian hospitals from 1 October 2005 to 30 September 2006 were included.

Results

Were detected 220 cases, the incidence was 0.58 cases/1,000 hospital discharges. Candida albicans was the most frecuent species (53 % of cases). The majority of isolates (89 % ) was susceptibility to fluconazole. Sepsis was the most frequent clinical manifestation (65.7 % ). The treatment was inadequate in 38.7 % of cases. Overall mortality was 40 % .

On univarite analysis death was found to be significantly associated with: aged > 60 years, unknown candidemia focus, Pitt score ?2, APACHE II, shock at onset, persistents positive second blood cultures, non-removal of the central venous catheter and Candida species different of C. parasilopsis, among others. In the multivariate analysis death was found to be significantly associated with: aged > 60 years, Pitt score ?2, Candida specise different of C.parasilopsis and inadequate treatment.

Conclusions

The candidemia clinical epidemiology in our region is similar to other areas and receiving inadequate treatment is the only modifiable risk factor associated with higher odds of mortality. Therefore, this modifiable factor needs to be improved to reduce the mortality.