Epidemiology, species distribution, antifungal susceptibility, and outcome of candidemia across five sites in Italy and Spain
| Autor: | Anna Parra, Mario Tumbarello, Jordi Rello, Assunta Sartor, José Garnacho-Montero, Maria Merelli, Roberto Luzzati, Brunella Posteraro, Elda Righi, Ana Díaz-Martín, Matteo Bassetti, Enrico Maria Trecarichi, Eva María Roselló, Maurizio Sanguinetti |
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| Přispěvatelé: | M., Bassetti, M., Merelli, E., Righi, A., Diaz Martin, E. M., Rosello, Luzzati, Roberto, A., Parra, E. M., Trecarichi, M., Sanguinetti, B., Posteraro, J., Garnacho Montero, A., Sartor, J., Rello, M., Tumbarello |
| Rok vydání: | 2013 |
| Předmět: |
Male
Pediatrics candidemia epidemiology antifungal susceptibility outcome Italy Spain Antifungal Agents law.invention Candida tropicalis Tertiary Care Centers chemistry.chemical_compound law Epidemiology 80 and over Candida Aged 80 and over biology Mortality rate Incidence (epidemiology) Incidence Middle Aged Intensive care unit Hospitals Adult Aged Candidemia Female Hospitals Teaching Humans Microbial Sensitivity Tests Survival Analysis Treatment Outcome Microbiology (medical) medicine.drug medicine.medical_specialty Mycology Settore MED/17 - MALATTIE INFETTIVE medicine Candida glabrata business.industry Teaching biology.organism_classification bacterial infections and mycoses chemistry Caspofungin business Fluconazole |
| Zdroj: | Journal of clinical microbiology. 51(12) |
| ISSN: | 1098-660X |
| Popis: | Candidemia has become an important bloodstream infection that is frequently associated with high rates of mortality and morbidity, and its growing incidence is related to complex medical and surgical procedures. We conducted a multicenter study in five tertiary care teaching hospitals in Italy and Spain and evaluated the epidemiology, species distribution, antifungal susceptibilities, and outcomes of candidemia episodes. In the period of 2008 to 2010, 995 episodes of candidemia were identified in these hospitals. The overall incidence of candidemia was 1.55 cases per 1,000 admissions and remained stable during the 3-year analysis. Candida albicans was the leading agent of infection (58.4%), followed by Candida parapsilosis complex (19.5%), Candida tropicalis (9.3%), and Candida glabrata (8.3%). The majority of the candidemia episodes were found in the internal medicine department (49.6%), followed by the surgical ward, the intensive care unit (ICU), and the hemato-oncology ward. Out of 955 patients who were eligible for evaluation, 381 (39.9%) died within 30 days from the onset of candidemia. Important differences in the 30-day mortality rates were noted between institutions: the lowest mortality rate was in the Barcelona hospital, and the highest rate was in the Udine hospital (33.6% versus 51%, respectively; P = 0.0005). Overall, 5.1% of the 955 isolates tested were resistant or susceptible dose dependent (SDD) to fluconazole, with minor differences between the hospitals in Italy and Spain (5.7% versus 3.5%, respectively; P = 0.2). Higher MICs for caspofungin were found, especially with C. parapsilosis complex (MIC 90 , 1 μg/ml). Amphotericin B had the lowest MICs. This report shows that candidemia is a significant source of morbidity in Europe, causing a substantial burden of disease and mortality. |
| Databáze: | OpenAIRE |
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