Changes in clinical features of fungemia in a Japanese University Hospital over a 12-year period.
Forty-five patients with fungemia during 1982-1993 (periods I = 1982, II = 1986-1989, III = 1990-1993) in a Japanese university hospital were reviewed to follow changes in the clinical features of fungemia. The percentage of fungi among microorganisms isolated from blood cultures was almost constant (6-10%) throughout the study period. Fungemia was highly associated with use of intravascular catheters, and some changes in clinical features were observed: 1) Candida albicans, C. parapsilosis and C. glabrata were the main isolates, and the number of fungal species showed a tendency to increase. 2) The percentage of patients over 65 years old increased from 36 to 50%. 3) The percentage of patients who were treated with anti-fungal agents and/or removal of catheter increased from 50 to 89 and to 86%. 4) The percentage of patients who died within 28 days after isolation of fungus decreased from 64 to 27%. The improved prognosis was thought to be due to the development of new anti-fungal agents and faster removal of intravascular catheter when infection was suspected.
First Department of Internal Medicine, Toyama Medical and Pharmaceutical University.
Y
Y
Mizushima
H
H
Li
I
I
Yoshida
R
R
Oosaki
M
M
Kobayashi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D002404:Catheterization / Q000295:instrumentation; D002648:Child; D004866:Equipment Contamination / Q000706:statistics & numerical data*; D005260:Female; D016469:Fungemia / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D006785:Hospitals, University; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D011379:Prognosis; D012307:Risk Factors; D013514:Surgical Procedures, Operative
D000935:Antifungal Agents