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[Candida fungemia].

G Zanetti1, T Calandra, B de Muralt

  • 1Département de médecine interne, Centre hospitalier universitaire vaudois, Lausanne.

Schweizerische Medizinische Wochenschrift
|September 9, 1989
PubMed
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Nosocomial fungemia, often caused by Candida albicans, is a serious infection. Antifungal treatment significantly reduces mortality in patients with fungemia.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Hospital Epidemiology

Background:

  • Fungemia, a bloodstream infection caused by fungi, poses a significant threat in hospital settings.
  • Candida species are a leading cause of fungemia, particularly in immunocompromised patients.
  • Understanding the epidemiology and outcomes of fungemia is crucial for effective patient management.

Purpose of the Study:

  • To analyze the clinical characteristics, risk factors, and outcomes of fungemia episodes caused by Candida species.
  • To evaluate the impact of antifungal therapy on mortality rates in patients with fungemia.
  • To identify common portals of entry and predisposing conditions associated with fungemia.

Main Methods:

  • Retrospective analysis of 52 fungemia cases due to Candida species from 1980-1986.

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  • Data collection included patient demographics, underlying conditions, prior bacteremia, clinical presentation, and treatment.
  • Statistical analysis compared outcomes between treated and untreated patient groups.
  • Main Results:

    • Fungemia was predominantly nosocomial (98%), occurring after a median hospital stay of 24 days.
    • Candida albicans was the most frequent isolate (71%), with the digestive tract (38%) and intravascular catheters (31%) as common entry points.
    • Patients receiving antifungal therapy (amphotericin B or ketoconazole) had significantly lower global and fungemia-related mortality rates compared to untreated patients (30% vs. 87% and 11% vs. 47%, respectively).

    Conclusions:

    • Nosocomial fungemia is associated with high mortality, particularly in patients with underlying conditions.
    • Prompt and appropriate antifungal therapy is critical for improving survival rates in fungemia patients.
    • Effective infection control measures and early diagnosis are essential to reduce the burden of fungemia in healthcare settings.