Candidemia in a Portuguese tertiary care hospital: Analysis of a 2-year period
| Autor: | André Silva-Pinto, Beatriz Prista-Leão, Sara Lacerda, Aline C. Martins, Lurdes Santos, Rita Filipe, S. Pinto-Magalhães, Daniel Moraes Pinheiro |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Antifungal Agents Adolescent medicine.medical_treatment Antifungal drugs Tertiary Care Centers 03 medical and health sciences High morbidity Young Adult Pharmacotherapy Risk Factors Internal medicine Prevalence Medicine Humans Prospective Studies Prospective cohort study Candida albicans Aged Candida Retrospective Studies 0303 health sciences Cross Infection biology Portugal 030306 microbiology business.industry Age Factors Candidemia Disease Management Retrospective cohort study Tertiary care hospital Middle Aged biology.organism_classification Prognosis Infectious Diseases Treatment Outcome Female business Central venous catheter |
| Zdroj: | Journal de mycologie medicale. 29(4) |
| ISSN: | 1773-0449 |
| Popis: | Background Candidemia is a nosocomial infection of increasing importance, associated with high morbidity and mortality. The aim of this study is to describe the species distribution, risk factors, management and outcomes of patients with candidemia. Methods We conducted a retrospective study at Centro Hospitalar Universitario de Sao Joao, Portugal, between January 2016 and December 2017. Results A total of 117 candidemia episodes (n = 114 patients) were included. Median age was 65 years, with an increased prevalence of older ages. Candida albicans (51.3%) was the most prevalent species, followed by C. glabrata (22.2%), C. parapsilosis (15.4%), C. tropicalis (4.3%) and C. lusitaniae (2.6%). Forty-two patients (35.9%) did not receive antifungal drugs after diagnosis of candidemia. Echinocandins were used as first-line drug therapy in half of the treated patients (50.7%). The median EQUAL Candida Score was 6/17 (IQR 6-9) for patients without central venous catheter (CVC) and 11/20 (IQR 6-14) for patients with CVC. The 30 days-mortality was 31,6% and was not significantly associated with the timing of antifungal therapy and the EQUAL Candida Score. Conclusion The distribution of Candida species has changed in recent years, with an increase in the proportion of C. albicans and C. glabrata. Rapid diagnostic tests, empiric antifungal therapy and source control are essential to improve the prognosis of patients with candidemia. More multicentric prospective studies are needed to evaluate the association of mortality with the timing of antifungal therapy or the EQUAL Candida Score. |
| Databáze: | OpenAIRE |
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