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Experience with invasive Candida infections
H Girishkumar1, A M Yousuf, J Chivate
1Department of Surgery, Bronx-Lebanon Hospital Center, NY 10457, USA.
Abstract:
Between January and July 1995, 227 patients at the Bronx-Lebanon Hospital Center had positive fungal cultures. Candida spp were the most common fungi isolated. Forty-three patients with invasive disease, as indicated by fungus-positive blood cultures, became the focus of our study. C albicans caused fungaemia in 21 patients (49%). Twenty-eight patients (65%) were less than 50 years of age; three were neonates. The most common presenting symptoms were fever, chills, and weakness (20 patients, 47%). Thirty patients died, giving a mortality rate of 70%. The patients who died stayed in the hospital an average of 49 days. The highest mortality occurred among patients who became bacteraemic before or at the same time they became candidaemic (24 of 26 patients) or who were receiving broad-spectrum antibiotics (20 of 26 patients). We also found high mortality rates from invasive fungal infection among patients with HIV infection, a central venous catheter, and liver, renal, or respiratory failure. We did not find any increase in the incidence of invasive fungal infection or mortality among leukopenic or diabetic patients.
Insights
Invasive fungal infections, primarily Candida albicans, led to a 70% mortality rate in a 1995 Bronx study. Risk factors included concurrent bacteremia and broad-spectrum antibiotic use.
Area of Science:
- Infectious Diseases
- Mycology
- Clinical Microbiology
Background:
- Fungal infections pose a significant threat in hospital settings.
- Candida species are common causes of invasive fungal disease.
- Understanding risk factors and outcomes is crucial for patient management.
Purpose of the Study:
- To investigate the incidence, characteristics, and mortality of invasive fungal infections.
- To identify risk factors associated with increased mortality.
- To analyze the clinical presentation and outcomes of patients with positive fungal cultures.
Main Methods:
- Retrospective analysis of 227 patients with positive fungal cultures from January to July 1995.
- Focus on 43 patients with invasive fungal disease (fungus-positive blood cultures).
- Data collection on patient demographics, clinical symptoms, comorbidities, treatments, and outcomes.
Main Results:
- Candida species were the most common isolates, with Candida albicans causing 49% of fungemia.
- The overall mortality rate for invasive fungal infection was 70% (30 deaths).
- Higher mortality was observed in patients with concurrent bacteremia, broad-spectrum antibiotic use, HIV infection, central venous catheter, and organ failure.
Conclusions:
- Invasive fungal infections, particularly candidemia, are associated with high mortality.
- Prompt identification and management of risk factors are essential.
- Further research into preventative strategies and targeted therapies is warranted.