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Fungemia: analysis of 43 cases
Abstract:
This report reviews the cases of 43 patients with 48 episodes of fungemia, and examines the clinical significance of fungemia and the results of treatment. All episodes were nosocomial infections. Candida albicans (60.4%), Candida parapsilosis (16.7%), and Candida tropicals (14.6%) were the most common fungal pathogens isolated from blood cultures. Patients with Candida albicans had a better survival rate than those with other species (p = 0.011). Polymicrobial fungemia was noted in 5 patients (11.6%). Most patients had underlying diseases and predisposing factors. Intravascular catheters (100%), broad-spectrum antibiotics administration (100%), surgical procedures (46.5%) and total parental alimentation (41.9%) were the most common predisposing factors. The clinical manifestations were not characteristic and consisted of nonspecific signs of sepsis. The overall mortality rate was 79%. We did not find any improvement in the mortality rate of our patients treated with amphotericin B. Early recognization, immediate removal of predisposing factors, and correction of underlying conditions is most important for patients with fungemia. We also suggest that fungal infection should be considered early when a febrile patient at high risk dose not improve with broad-spectrum antibacterial therapy.
Insights
This study on fungemia found Candida albicans infections had better survival rates. Early recognition and intervention are crucial for improving outcomes in these serious hospital-acquired infections.
Area of Science:
- Infectious Diseases
- Mycology
- Critical Care Medicine
Background:
- Fungemia, a serious bloodstream fungal infection, is often acquired in hospitals (nosocomial).
- Commonly identified fungal pathogens include Candida albicans, Candida parapsilosis, and Candida tropicalis.
- Predisposing factors are prevalent, including intravascular catheters, broad-spectrum antibiotics, and surgery.
Purpose of the Study:
- To review cases of fungemia, analyze clinical significance, and evaluate treatment outcomes.
- To identify common fungal pathogens and their associated survival rates.
- To determine the impact of predisposing factors and treatment on mortality.
Main Methods:
- Retrospective review of 48 episodes of fungemia in 43 patients.
- Identification of fungal pathogens from blood cultures.
- Analysis of clinical data, predisposing factors, treatments, and outcomes.
Main Results:
- Candida albicans was the most frequent pathogen (60.4%), associated with a better survival rate (p=0.011).
- The overall mortality rate was high at 79%.
- Amphotericin B treatment did not show a significant improvement in mortality rates.
Conclusions:
- Early recognition and management of predisposing factors are critical for fungemia patients.
- Fungal infection should be suspected in high-risk febrile patients unresponsive to antibacterial therapy.
- Fungemia remains a significant challenge with high mortality, necessitating prompt and comprehensive care.