Candidaemia in critically ill patients, 2005-2010

Ref ID: 17740

Author:

R. Patel*, B. Saberwal, S. Quan, A. Gonzalez-Ruiz

Author address:

(London, UK)

Full conference title:

22nd European Congress of Clinical Microbiology and Infectious Diseases

Abstract:

Objectives: To provide a picture of local epidemiology and to assess
whether appropriate antifungal therapy is administered in a timely
fashion. To evaluate risk factors, outcome and the associated costs.
Methods: Retrospective analysis of all candidaemias between January
2005 and December 2010 at a 460 bed district general hospital.
Results: There were a total of 60 candidaemias between 2005-2010
resulting in a prevalence of 0.24 per 1000 patient admissions. The most
predominant species were C. albicans which accounted for 43 cases
(73%). From a total of 60 candidaemias, 55 cases were investigated
further. It was found that 56% of cases were diagnosed in intensive care
(ITU) resulting in ITU prevalence of 9.4 per 1000 admissions compared
to a non ITU prevalence of 0.10 per 1000 admissions. This equates to
approximately a 100-fold difference between ITU and non ITU cases,
consistent with previous reports. The most common risk factor was a
central venous pressure line (67%). Forty out of 45 (88.9%) patients
received appropriate antifungal treatment within 24 hours of positive
blood culture.
From a total of 54 candidaemias, crude mortality rate was 36.6% (15/
41) and 46.2% (6/13) for C. albicans and non-albicans Candida
respectively. The difference between the crude mortality is 9.6% and is
not significant (p = 0.75, Fisher’s exact test). Hospitalization plus
antifungal costs were ≤48 698/pt and ≤67 809/pt for the C. albicans and
non-albicans Candida groups respectively. The average length of stay
per patient was 58 bed days however, the C. albicans group accounted
for 18.6 bed days/pt in ITU and 34.5 bed days/pt in non ITU wards,
compared to the non-albicans Candida group who accounted for 23.8
bed days/pt in ITU and 50.7 bed days/pt in non ITU wards.
Conclusions: 88.9% of patients received timely antifungal treatment.
There is a high mortality rate in patients with candidaemias. The care of
C. albicans infections was on average ≤19 111/pt cheaper. Trust
outcome would be to devise and implement a candidaemia score card to
improve outcomes and costs.

Abstract Number: NULL

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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