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Nosocomial fungaemia: a 2-year prospective study
S F Costa1, I Marinho, E A Araújo
1Nosocomial Infection Control Group of Hospital das Clinicas of University of São Paulo, Brazil.
Abstract:
Eighty-six consecutive patients with fungaemia were studied during a period of 2 years, 81% had two or more positive blood cultures. Gastrointestinal tract (28%) and haematological diseases (17%) were the most common underlying conditions. The majority of cases had received vancomycin and/or imipenem (87%) and a central venous catheter (78%). Candida albicans (50%) and Candida parapsilosis (17%) were the most frequent isolates. Overall mortality was 41%, and for patients with Candida tropicalis was 71%. There was not significant difference in survival with gender, age and days of treatment with antifungal drugs. Haematological diseases, neutropenia and a higher number of positive blood cultures were associated with poor outcome.
Insights
This study on fungemia found that while Candida albicans is the most common cause, underlying conditions like hematological diseases and neutropenia significantly increase mortality risk. Early identification and treatment are crucial for better patient outcomes.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Clinical Microbiology
Background:
- Fungemia, a serious bloodstream fungal infection, poses a significant global health challenge.
- Identifying common causative agents and risk factors is crucial for effective management.
- Previous studies highlight varying epidemiological patterns and outcomes of fungemia.
Purpose of the Study:
- To investigate the clinical characteristics, risk factors, and outcomes of fungemia in a cohort of patients.
- To identify the most frequent fungal species causing fungemia and their associated mortality rates.
- To determine factors influencing patient survival in fungemia cases.
Main Methods:
- Retrospective analysis of 86 consecutive fungemia patients over 2 years.
- Data collection included underlying conditions, treatments, fungal isolates, and mortality.
- Statistical analysis to identify factors associated with poor outcomes.
Main Results:
- 81% of patients had multiple positive blood cultures.
- Gastrointestinal tract (28%) and hematological diseases (17%) were common underlying conditions.
- Candida albicans (50%) and Candida parapsilosis (17%) were most frequent isolates.
- Overall mortality was 41%, with Candida tropicalis cases showing 71% mortality.
- Hematological diseases, neutropenia, and multiple positive cultures correlated with poor outcomes.
Conclusions:
- Fungemia remains a critical condition with high mortality, particularly in patients with hematological diseases.
- Prompt diagnosis and targeted antifungal therapy are essential.
- Further research into preventative strategies and novel treatments is warranted.