Incidence, risk factors, and predictors of outcome of candidemia. Survey in 2 Italian university hospitals
- 作者：Matteo Bassetti ; Enrico Maria Trecarichi ; Elda Righi ; Maurizio Sanguinetti ; Francesca Bisio ; Brunella Posteraro ; Ornella Soro ; Roberto Cauda ; Claudio Viscoli ; Mario Tumbarello
- 关键词：Candidemia ; Hospital ; Risk factors ; Incidence
- 刊名：Diagnostic Microbiology and Infectious Disease
- 出版年：2007
- 期刊代码：79_07328893
- 类别：med
- 出版时间：July 2007
- 卷：58
- 期：3
- 页码：325-331
- 文件大小：150 K
摘要
In recent decades, Candida spp. emerged as the fourth most common cause of nosocomial bloodstream infections. The incidence of candidemia was 0.13 per 100 persons. Eighty-three cases (61%) of candidemia were due to Candida albicans and 53 (39%) to nonalbicans Candida spp. Twelve strains of Candida (9%) had shown in vitro resistance to fluconazole, 5 (4%) to itraconazole, 2 (1.5%) to voriconazole, 12 (9%) to 5-flucytosine, and 1 (0.7%) to amphotericin B. Multivariate logistic regression analysis of risk factors showed that length of hospitalization, presence of a central venous catheter, previous episodes of candidemia or bacteremia, parenteral nutrition, and chronic renal failure were variables independently associated with the development of candidemia. Multivariate logistic regression analysis of prognostic indicators showed that the independent variables associated with poor prognosis were inadequate initial therapy (P < .001) and high APACHE III score (P = .004). The inadequate initial therapy associated with mortality indicates the need for additional investigations to define high-risk patients for beneficial antifungal prophylaxis.