title: Management and outcome of bloodstream infections due to Candida species in England and Wales.
abstract: This two-year prospective hospital population-based study of candidaemia is the first to be conducted in the UK. It was carried out on behalf on the British Society for Medical Mycology (BSMM) as part of the European Confederation of Medical Mycology (ECMM) epidemiological survey of candidaemia. Six hospitals in England and Wales acted as sentinel hospitals. Main outcome measures were hospital population-based incidence and 30-day mortality. There were 18.7 episodes of candidaemia per 100,000 finished consultant episodes or 3.0/100,000 bed days and 45.4% cases occurred in intensive care unit (ICU) patients. Candida albicans was isolated in 64.7% of confirmed cases. The majority of isolates were sensitive to standard antifungal agents, including fluconazole. The overall 30-day mortality was 26.4% and removal of the central venous catheter was associated with a significant reduction in mortality. In conclusion, the incidence of candidaemia in England and Wales is similar to that of the USA, the majority of isolates remain sensitive to commonly used antifungal agents and mortality associated with this infection appears to be falling.
authors.affiliation: Department of Medical Microbiology, Royal Free and University College Medical School, Pond Street, London NW3 2QG, UK.
authors.forename: C C
authors.initials: CC
authors.lastname: Kibbler
authors.forename: S
authors.initials: S
authors.lastname: Seaton
authors.forename: R A
authors.initials: RA
authors.lastname: Barnes
authors.forename: W R
authors.initials: WR
authors.lastname: Gransden
authors.forename: R E
authors.initials: RE
authors.lastname: Holliman
authors.forename: E M
authors.initials: EM
authors.lastname: Johnson
authors.forename: J D
authors.initials: JD
authors.lastname: Perry
authors.forename: D J
authors.initials: DJ
authors.lastname: Sullivan
authors.forename: J A
authors.initials: JA
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D002177:Candidiasis / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D025141:Drug Resistance, Fungal; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D018571:Sentinel Surveillance; D014852:Wales / Q000453:epidemiology
chemical_list: D000935:Antifungal Agents