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[Nosocomial fungemia caused by Candida parapsilosis]
J A Herrero1, C Lumbreras, F Sanz
1Servicio de Microbiología Clínica, Hospital 12 de Octubre, Madrid.
Abstract:
We review 27 episodes of nosocomial fungemia due to Candida parapsilosis over a 6 year period, compared to a control group of 27 episodes of nosocomial fungemia due to Candida albicans. During the study period, C. parapsilosis accounts for 23% of all yeast isolated from blood-cultures. Fungemia due to C. parapsilosis was more frequently seen in males (23/4). More than half of the cases (15/27) presented in the postoperative period. In 89% of cases the patients were under total parenteral nutrition and 81% had received broad-spectrum antibiotics. In 41% of cases, the source of the fungemia was unknown, and in another 41% of cases was related to an iv line infection. Direct attributable mortality to C. parapsilosis infection was 11%. When compared to the control group, nosocomial fungemia due to C. parapsilosis occurs in patient with more prolonged courses of total parenteral nutrition, and also was related with less frequent development of septic shock and lower attributable mortality.
Insights
Candida parapsilosis causes hospital-acquired fungemia, often in male patients post-surgery. This yeast infection is linked to prolonged parenteral nutrition but has lower mortality than Candida albicans.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Hospital Epidemiology
Context:
- Nosocomial fungemia is a significant concern in healthcare settings.
- Candida parapsilosis is an emerging cause of bloodstream infections.
- Understanding risk factors and outcomes is crucial for patient management.
Purpose:
- To compare nosocomial fungemia caused by Candida parapsilosis versus Candida albicans.
- To identify clinical characteristics and outcomes associated with C. parapsilosis fungemia.
- To evaluate the attributable mortality of C. parapsilosis fungemia.
Summary:
- A review of 27 episodes of nosocomial fungemia due to Candida parapsilosis (CP) and 27 episodes due to Candida albicans (CA) was conducted.
- CP fungemia occurred more frequently in males, often in the postoperative period, and was associated with prolonged total parenteral nutrition (TPN) and broad-spectrum antibiotic use.
- Sources included unknown origins or intravenous line infections. CP fungemia showed less frequent septic shock and lower attributable mortality compared to CA.
Impact:
- This study highlights key differences in patient populations and outcomes between CP and CA nosocomial fungemia.
- Findings can inform targeted prevention strategies and clinical management for patients with CP bloodstream infections.
- The data suggests CP fungemia may be less virulent than CA fungemia, impacting treatment decisions and resource allocation.