Invasive candidiasis: a one-year prospective study in Western France

JP Talarmin, D. Boutoille, O. Morin, P. Tattevin, R. Verdon, J. Ganji, S. Ansart, F. Raffi, Gericco Group

Abstract: 

Objectives: Candida species-have Emerged as a Major causes of bloodstream infections. We Conducted a study of candidemia 12 months in 2004, in order to collect data on epidemiology, antifungals susceptibility, risk factoring, treatment and outcome.

Methods: a multicenter prospective observational study of patients with positive blood cultures for Candidaspecies.

Results: One hundred and ninety patients Developed candidemia, of Whom Were 63% men. The median age Was 65 (range: 0.5 to 93) years. Candida albicans Accounted for 55% of cases, Candida glabrata , 19% andCandida parapsilosis , 13%. Most Candida glabrata isolates (58%) Were susceptible to fluconazole, and 31% Were susceptible dose-dependent. The main risk factoring for candidemia Were: broad-spectrum antibiotics (76%), central venous catheter (73%), surgery (41%), hospitalization in ICU (32%), corticosteroid use (30%), cancer (28% ), hematologic malignancy (19%). The median number of risk factoring Was 5 (range: 0 to 10).Antifungal therapy Was Given for a median duration of 20 (range: 1 to 161) days. The first-line antifungal agent fluconazole Was in 67% of the cases, and amphotericin B in 15%. Therapeutic regimens included voriconazole or caspofungin in 12.1% and 22.6% respectivement. The overall mortality Was 47.9%, 2 factoring Were associated with a Higher mortality rate: Candida species (mortality: 44.2% for Candida albicans , vs. 52.3% for non- albicans Candida species, NS) and age (56.6% mortality for patients < 60, vs. 36.6% for patients <60, p = 0.006).

Conclusion: In this large prospective survey, non- albicans Candida species Accounted for Nearly half boxes of candidemia. Almost all patients multiple HAD risk factoring. DESPITE availability of the new antifungal agents, mortality rate Was high and Increased Both by old age and presence of non- albicans Candida species. =

2005

Full conference title: 

Réunion Interdisciplinaire de Chimiothérapie Anti Infectieuse
    • RICAI 25th (2005)