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Fungemia in non-HIV-infected patients: a five-year review

Siriluck Anunnatsiri1, Ploenchan Chetchotisakd, Piroon Mootsikapun

  • 1Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. asiril@kku.ac.th

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|July 26, 2008
PubMed
Abstract

Insights

Fungemia, particularly candidemia caused by non-albicans Candida, is a significant hospital-acquired infection in Thailand. High mortality rates underscore the need for rapid diagnosis and early treatment in critically ill patients.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Hospital Epidemiology

Background:

  • Fungal infections, or fungemia, pose a significant threat in healthcare settings, especially in non-HIV-infected individuals.
  • Understanding the epidemiology and risk factors of fungemia is crucial for effective patient management and infection control.

Purpose of the Study:

  • To determine the incidence, risk factors, causative agents, and outcomes of fungemia in adult patients without HIV infection.
  • To identify specific fungal species responsible for fungemia and analyze their clinical impact.

Main Methods:

  • A retrospective study of 147 fungemia episodes caused by Candida spp. and Trichosporon spp. in adult patients.
  • Data collected from a university hospital in Northeast Thailand between 1999 and 2003.

Main Results:

  • The incidence of fungemia was 14.1 per 10,000 hospital admissions.
  • Candida species, predominantly non-albicans Candida (68.7%), were the most common cause (93.9%). Trichosporon fungemia occurred in 6.1% of cases.
  • Overall in-hospital mortality was 56.1%, with high APACHE II scores, assisted ventilation, and neutropenia identified as independent risk factors for mortality.

Conclusions:

  • Candidemia, especially from non-albicans Candida, is a critical nosocomial infection in this Thai tertiary care hospital.
  • High mortality rates, particularly in critically ill patients, highlight the urgent need for prompt diagnosis and treatment.
  • Improving clinical outcomes requires addressing challenges in rapid diagnosis and early therapeutic interventions.

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