Survey of candidemia in an Intensive Care unit

Skiada, A., Pavleas, .I ,Thomopoulos, G., Rigas, K., Mega, A., Vernikos, P., Archontoulis2, N., Stefanou3, I., Salatas2, K., Rigas2, A., Chatzihannas4, L., Floros2, I., Petrikkos4, G.

Author address: 

1 University of Athens, ATHENS, Greece 2Laikon Hospital, ICU, ATHENS, Greece 3 Laikon Hospital, Microbiology Department, ATHENS, Greece 4University of Athens, 1st Department Prop.Med., ATHENS, Greece


Aim: Candida is an important pathogen in the hospital setting and especially in the ICU. The aim of this study was to analyze the morbidity and mortality related to candidemia in our ICU, as well as to record the isolated species of the fungus. Material and Methods: Prospective epidemiological study, in a mixed ICU. The patients who stayed in the ICU for less than 48 hours were excluded from the study. The demographic characteristics of all the other patients admitted were recorded, as well as the underlying diseases, disease severity as estimated by the APACHE II score and possible predisposing factors, such as presence of central venous catheters, diabetes mellitus, renal failure, etc. The species of Candida isolated from blood cultures was identified with Chromagar and API32. Results: The study started on August 2004 and is in progress. We report the results of the first 33 months. During this period 302 patients were included in the study. Their mean age was 66 years, 59% of them were male and their mean APACHE II score was 18. Twenty-one episodes of candidemia were recorded in seventeen patients. In six cases the same Candida was also isolated from the tip of the removed central venous catheter. The isolated species were C.albicans (7), C.parapsilosis (6), C.glabrata (4), C.krusei (1), C.famata (1), C.lusitaniae (1), and C.tropicalis (1). The C.glabrata strains were all resistant to fluconazole, two were intermediately and one fully resistant to voriconazole, while the C.parapsilosis, C.tropicalis and C.lusitaniae, as well as the C.albicans strains were susceptible to all antifungals tested, with the exception of one isolate of C.parapsilosisresistant to caspofungin. The crude mortality of the patients who developed candidemia was 70%, while the mortality of all patients who were hospitalized at the ICU for more than 48 hours was 38%. Conclusions: A significant percentage of patients in our ICU (6%) develop bloodstream infections due to Candida sp. Of the isolated species 66% are non- albicans. Mortality is increased in patients with candidemia.

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Full conference title: 

3rd Trends in Medical Mycology
    • TIMM 3rd (2011)