title: Candidemia at a tertiary-care hospital: epidemiology, treatment, clinical outcome and risk factors for death.
abstract: The demographic, clinical and microbiological data of patients with candidemia at the "Hopital Universitario La Fe", a tertiary-care hospital in Valencia, Spain, from 1995 to 1997 was analyzed retrospectively. Candida spp. were isolated in blood cultures from 145 patients, 32% of whom were children (25% of these were neonates). The most common species isolated was Candida albicans, followed by Candida parapsilosis, Candida krusei and Candida tropicalis. Risk factors for candidemia included underlying disease, therapy with broad-spectrum antibiotics and the presence of a central venous catheter. The majority of children were treated with amphotericin B, whereas 52% of adults received fluconazole. Overall mortality was 44% (30% in children and 50% in adults), and attributable mortality was 30% (24% in children and 33% in adults). Multivariate analysis indicated that neutropenia, corticosteroid therapy, lack of antifungal treatment, and failure to replace the central venous catheter were factors associated with candidemia-related death. Among the adult population, an APACHE II score greater than 15 predicted candidemia-related death.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, The University of Texas, Health Science Center at San Antonio, USA. angelviudes@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Viudes
authors.forename: J
authors.initials: J
authors.lastname: Pemán
authors.forename: E
authors.initials: E
authors.lastname: Cantón
authors.forename: P
authors.initials: P
authors.lastname: Ubeda
authors.forename: J L
authors.initials: JL
authors.lastname: López-Ribot
authors.forename: M
authors.initials: M
authors.lastname: Gobernado
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use*; D002175:Candida / Q000145:classification* / Q000302:isolation & purification; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D016469:Fungemia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis
chemical_list: D000935:Antifungal Agents