Candidemia in a Tertiary Care Hospital: Epidemiology, Outcomes, and Risk Factors for Death

SASISOPIN KIERTIBURANAKUL, MD, ANUSITH TUNHASIRIWET, MD, MALAI VORACHIT, D Sc, KUMTHORN MALATHUM, MD;

Author address: 

Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand.

Abstract: 

Background: Candidemia is increasingly encountered in hospitalized and critical ill patients with a high morbidity and mortality. Candida albicans is still considered the most common frequently isolated species of patients with candidemia, the emergence of non-albicans Candida species is clearly concern. The aim of this study was to describe epidemiology on adult patients with candidemia and identify the prognostic factors associated for death. Methods: Demographic information, risk factors, therapy, and outcome of adult patients with candidemia were retrospectively reviewed from 2000 to 2002. Multivariate analyses were performed to identify factors associated with candidemia-related death using stepwise logistic regression. Results: A total of 125 patients with candidemia were identified and 101 patients had medical records available for review. The average annual incidence was 30.2 cases per 10,000 discharges. The mean age of 56±17 (range, 168722;92) years and 51% were male. Of these, 94% were hospital acquired infection. Common associated underlying conditions included antimicrobial therapy (97%), urinary catheter (68%), and central venous catheter (66%). The most common species isolated were C. albicans (37%), followed by C. tropicalis (29%), and C. glablata (18%). The overall mortality was 51%. The log-rank test showed that the presence of hematologic malignancy (P=0.013), concomitant bacteremia (P=0.004), neutropenia (P=0.002), retained central venous catheters (P=0.001), receiving corticosteroid (p=0.003), and immunosuppressive drugs (P=0.001) were statistically significant factors for death. The Cox Proportional Hazard Model indicated that septic shock (P=0.001; hazard ratio (HR) 3.50: 95% confidence interval (CI) 1.698722;7.23), previous chemotherapy (P
2004

abstract No: 

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Full conference title: 

42nd Annual Meeting Infectious Diseases Society of America
    • Infectious Diseases Society of America 42nd