Epidemiology and outcome of candidaemia at an acute-phase community hospital
Abstract number: R2460
Saito T., Aoki Y.
Objectives: To clarify the frequency of candidaemia, isolated Candida species, and prognosis at an acute-phase community hospital, we retrospectively analysed the clinical and microbiological data concerning the cases of Candida species detected from blood between June, 2003 and February 2006.
Patients and Methods: In cases that candida species were isolated, we recorded age, sex, underlying disease, identification and susceptibility for isolated candida species, doses of antifungal agents, duration of the therapy, presence or absence for ophthalmic examination, and outcome. Microbiological examination was carried out by an examination company. Species identification was confirmed with the VITEK YBC system or API 20 C AUX or API 32ID. The susceptibility testing was performed by the use of a commercially prepared colorimetric microdilution panel (ASTY®).
Results: In 329 patients with bacteraemia and/or candidaemia, 15 patients (4.6%) were candidaemia. The mean age was 79.5 years. There were 8 men and 7 women. The underlying diseases were malignancy (n = 7), cerebral infarction (n = 3), chronic renal failure (n = 1) and others (n = 4). The isolated organisms were C. albicans (n = 5) C. parapsilosis (n = 5), C. tropicalis (n = 2), C. glabrata (n = 2) and non-identified candida species (n = 1). In the 15 patients, a central venous catheter (CVC) had been inserted which was removed before determination of the species identification. In 12 patients that culture examination of CVC tip was carried out, the same Candida species in the blood was detected in 4 patients (33.3%). Thirteen of the 15 patients with candidaemia (86.7%) were not performed the ophthalmic examination for candida endophthalmitis. The patients with candidaemia were treated with a daily dose of 100 mg to 400 mg of fluconazole (n = 10), and of 250 mg of micafungin (n = 1). Two patients received no treatment. Two patients died before the species identification. Nine of the 15 patients (60.0%) died within the 30 days following a positive blood culture. The susceptibility of isolates to fluconazole was sensitive (n = 11) and susceptible dose/delibery-dependent (n = 4).
Conclusions: In community hospitals, it is important that physicians are cognizant of the possible occurrence of candidaemia in the patients with CVC. Furthermore, if candidaemia occurred, appropriate antifungal therapy and the ophthalmic examination for candida endophthalmitis are also important.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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