Nosocomial candidemia in a tertiary care hospital in Saudi Arabia.
Demographic information, risk factors, therapy, and outcome for all patients who had candidemia at King Fahad teaching hospital Al-khobar, between January 1995 and January 2000 were retrospectively reviewed. Thirty-two candidemic patients were identified. Candida parapsilosis was the most frequently isolated species (44%), followed by Candida tropicalis (25%), Candida albicans (19%), Candida krusei (6%), Candida glabrata (3%), and Candida guilliermondi (3%). Risk factors included recent broad-spectrum antibiotics use (100%), ICU residency (71%), central venous catheters (66%), recent surgery (56%), total parenteral nutrition (43%), and immunosuppressive therapy (31%). Fluconazole was used before the onset of candidemia in only two patients. The overall mortality rate was 44%. Eight (25%) episodes of candidemia were not diagnosed and treated before the patient's demise. In view of the high mortality rate associated with hematogenous candidiasis, and lack of sensitive and specific laboratory tests necessary for the premortem diagnosis of infection, empirical antifungal therapy is recommended for high-risk patients.
Bukharie
H A
HA
King Fahad Hospital of the University Al-khobar, Saudi Arabia. Hudawe000@yahoo.com
D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002175:Candida / Q000145:classification* / Q000302:isolation & purification*; D002177:Candidiasis / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D016469:Fungemia / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D006745:Hospital Bed Capacity, 300 to 499; D006761:Hospitals; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology
D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole