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Incidence of newer antifungal consumption and incidence of Candidaemia in an adult intensive care unit

Abstract number: P1800

Garbino J., Vernaz N., Peant C., Bouchuiguir-Wafa K., Rohner P., Romand J.

Objectives: A large proportion of nosocomial infections are acquired in intensive care units (ICU). Candida spp. are the leading non-bacterial nosocomial pathogens, and candidaemia carries a high risk of mortality in critically ill patients. Candida spp. are responsible for the majority of nosocomial fungal infections.

The study objectives were to describe the local epidemiology of candidaemia in the ICU of a tertiary care hospital, to analyse the sensitivity of Candida strains to the antifungal compounds and to describe the consumption of the newer antifungals compounds.

Methods: Hospital medical records of adult patients with candidaemia were reviewed from January 2000 to December 2006. We analysed the candidaemia episodes at the adult ICU of the institution. Demographic information and overall mortality were retrieved. We tested the susceptibility of Candida strains isolated during the last five years in our institution.

Results: A total of 212 episodes of candidaemia occurred in the institution. 49 (23%) developed in the ICU: 67% in surgical ICU and 33% in medical ICU. The median age of patients with candidaemia was 54.7 years; 27 (55%) were males. The mortality rate was 39%. Candida albicans was responsible for 71% (n = 35) of infections acquired in ICUs. Non-albicansCandida species (29%) were equally distributed throughout the study period. C. glabrata was identified in 8 episodes (16%), followed by C. parapsilosis in 2 (4%), C. tropicalis in 3 (6%), and unspecified Candida species in 1 (2%). During the study period no switch was noted in the distribution of C. albicans and non-albicansCandida species. The range of candidaemia incidence varied from 0.6 to 3.4 episodes/1000 patients throughout the study period. Most strains of C. albicans (94%) remained highly sensitive to fluconazole and all the newer antifungals tested. A decrease of the use of Amphotericin B was observed. A trend to increase the consumption of the newer antifungal compounds was observed from 2,200 DDD/year to 3,000 DDD/year.

Conclusion: Fungal infection remains a severe disease associated with high crude mortality. We observed a variable incidence of candidaemia during the study period. C. albicans was the most commonly isolated species. A trend to increase the use of the newer antifungal compounds consumption was observed but not a decrease in candidaemia incidence.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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