European Confederation of Medical Mycology (ECMM) prospective survey of candidaemia: report from one Italian region.
An ECMM epidemiological prospective survey of candidaemia was performed in one Italian region (Lombardy; population: 8 924 870) by the National Society of Medical Mycology (FIMUA) from September 1997 to December 1999. In total, 569 episodes were reported with an overall rate of 0.38/1000 admissions, 4.4/100000 patient days. Predisposing factors included presence of an intravascular catheter (89%), antibiotic treatment (88%), surgery (56%), intensive care (45%), solid tumour (28%), steroid treatment (15%), haematological malignancy (7%), HIV infection (6%), fetal immaturity (4%). Mucous membrane colonization preceded candidaemia in 83% of patients. Candida albicans was identified in 58% of cases, followed by Candida parapsilosis (15%), Candida glabrata (13%), Candida tropicalis (6%). Septic shock occurred in 95 patients. Crude mortality was 35%, the highest in C. tropicalis fungaemia (44%), the elderly (64%) and solid tumour cancer patients (43%). Intravascular catheter removal was associated with higher survival rate (71 vs. 47%). This survey underscores the importance of candidaemia in hospital settings.
Istituto di Igiene e Medicina Preventiva, Università-IRCCS Ospedale Maggiore, Milano, Italy. annamaria.tortorano@unimi.it
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Tortorano
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E
Biraghi
A
A
Astolfi
C
C
Ossi
M
M
Tejada
C
C
Farina
S
S
Perin
C
C
Bonaccorso
C
C
Cavanna
A
A
Raballo
A
A
Grossi
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002177:Candidiasis / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D015984:Causality; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D016469:Fungemia / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D006276:Health Facility Size; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies