Candidaemia in an intensive care unit
Abstract number: 1733_780
Rodriguez-Otero L., Villamil-Cajoto I., Cortizo S., Moldes L., Garcia-Zabarte M.A., Aguilera-Guirao A., Garcia-Riestra C., Regueiro B.
Objectives: The incidence of candidaemia a common and potentially fatal nosocomial infection has risen dramatically, and this increase has been accompanied by a shift in the infecting pathogen away from Candida albicans to treatment-resistant non-albicans species (NAS). In this study, we attempted to identify the risk factors for candidaemia caused by C. albicans and NAS.
Methods: We reviewed the clinical data on 80 inpatients with candidaemia at an Intensive Care Unit of our tertiary University Hospital in Spain, over a 5-year period. We defined mortality as occurring between days 3 to 30 after candidaemia.
Results:Candida albicans, C. parapsilosis, C. glabrata, C. tropicalis and C. krusei caused 46%, 38%, 5%, 3% and 3% of the candidaemia episodes, respectively. The overall mortality was 51% and it was highest in patients suffering from candidaemia of the albicans species (73%) compared NAS (40%). The risk factors to candidaemia caused by C. albicans and NAS respectively included: keeping the catheter in place more than 5 days 78%, 72%; use of total parenteral nutrition 32%, 51%; postoperative state of gastrointestinal tract surgery 35%, 44%; administration of broad-spectrum or combination antibiotics 5 days or more 78%, 77%; under corticosteroid therapy 47%, 36% and antifungal prophylaxis 19%, 28%. The medium length of hospital stay were 61 and 127 days.
Conclusions: Prophylactic azole antifungals, and the use of parenteral nutrition, may play an important role not only in the management of candidaemia but also in the proliferation of hard-to-treat candida species.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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