[Candidemia: characteristics in elderly patients].

Area of Science:

• Infectious Diseases
• Geriatric Medicine
• Critical Care Medicine

Background:

• Candidemia, a serious bloodstream infection, disproportionately affects elderly patients, yet specific data for this demographic is limited.
• Understanding candidemia in older adults is crucial due to their higher susceptibility and associated morbidity and mortality.

Purpose of the Study:

• To characterize candidemia in patients over 60 years old.
• To identify risk factors contributing to mortality in elderly candidemia patients.
• To assess the utility of a predictive scoring system for mortality in this population.

Main Methods:

• Retrospective observational study involving elderly patients (age > 60) diagnosed with Candida bloodstream infections.
• Analysis of 59 episodes of candidemia over an eight-year period at a tertiary care hospital.
• Evaluation of comorbidities, infection sources, mortality rates, and predictive score performance.

Main Results:

• Diabetes was the most common comorbidity; catheter-related infections accounted for 45% of cases.
• Overall mortality reached 49% by 15 days, with initial 48-hour mortality at 20%.
• Septic shock, mechanical ventilation, thrombocytopenia, renal failure, and leukocytosis were significant mortality predictors (p < 0.006); septic shock independently predicted mortality (HR 4.02).

Conclusions:

• Candidemia carries a high mortality risk in elderly patients, with nearly half succumbing within two weeks.
• Key factors predicting mortality include septic shock, need for mechanical ventilation, thrombocytopenia, renal failure, and leukocytosis.
• The evaluated predictive score demonstrated limited utility in this elderly patient cohort.