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Yeasts in blood cultures: impact of early therapy
A Rantala1, J Niinikoski, O P Lehtonen
1Department of Surgery, University Central Hospital of Turku, Finland.
Abstract:
Patients with growth of yeast in blood cultures were analyzed during the 6-year-period 1981-1986, with special regard to predisposing factors, mortality, severity of the disease and therapy. There were 80 isolations of yeasts in blood cultures in 39 patients and Candida albicans was the most common. The majority of the patients in the material had multiple predisposing factors. The overall mortality was 58%. Patients with d disseminated disease had a mortality of 79% in contrast to 32% in patients with transient fungemia. Disseminated disease was more common in surgical patients. The prognosis of patients treated within 4 days from the onset of septic symptoms was significantly better than that of patients with a later start of therapy. On the basis of these results we emphasize the importance of early empiric therapy.
Insights
Early empiric therapy for yeast in blood cultures significantly improves patient outcomes. This study highlights the importance of prompt treatment for candidemia, reducing high mortality rates associated with disseminated disease.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Clinical Medicine
Background:
- Yeast bloodstream infections (candidemia) pose a significant clinical challenge.
- Predisposing factors, disease severity, and treatment timing impact patient outcomes.
Purpose of the Study:
- To analyze predisposing factors, mortality, disease severity, and therapy in patients with yeast in blood cultures.
- To evaluate the impact of treatment timing on prognosis for candidemia.
Main Methods:
- Retrospective analysis of 80 yeast blood culture isolations from 39 patients between 1981-1986.
- Assessment of predisposing factors, disease classification (transient fungemia vs. disseminated disease), and treatment duration.
Main Results:
- Candida albicans was the most frequent yeast isolate.
- Overall mortality was 58%; disseminated disease had 79% mortality versus 32% for transient fungemia.
- Early treatment (within 4 days) significantly improved prognosis compared to later therapy.
Conclusions:
- Multiple predisposing factors are common in patients with candidemia.
- Prompt initiation of empiric antifungal therapy is crucial for improving survival rates.
- Disseminated candidemia, particularly in surgical patients, carries a high mortality risk.