title: Evaluation of species distribution and risk factors of candidemia: a multicenter case-control study.
abstract: This study was planned to determine the risk factors of candidemia, and the most common Candida species causing bloodstream infections. A case-control study which included adult patients was conducted over a 1-year period at tertiary-care educational hospitals in Turkey. A total of 83 candidemia episodes were identified during the study period. Candida albicans was the most common species recovered (45.8%) followed by Candida tropicalis (24.1%) Candida parapsilosis (14.5%) and Candida glabrata which was isolated from only four (4.8%) patients. Presence of a urethral catheter (odds ratio [OR] 2.38; 95% confidence interval [CI] 1.09-5.19; P = 0.02), previous use of antibiotics (OR 2.61; 95% CI 1.05-6.46; P = 0.03), RBC transfusions (OR 2.14; 95% CI 1.16-3.94; P = 0.01) and parenteral nutrition (OR 4.44; 95% CI 2.43-8.11; P < 0.01) were found as independent risk factors for candidemia. TPN (Total Parenteral Nutrition) was an independent risk factor for both C. albicans and non-Candida albicans Candida species (P < 0.001). Most of the risk factors were invasive procedures and former medications. We conclude that a great number of candidemia cases are preventable by means of reduction of unnecessary invasive procedures and the use of antimicrobials.
authors.affiliation: Infectious Diseases and Clinical Microbiology, Dokuz Eylul University, Izmir, Turkey. nuryapar@gmail.com
authors.forename: Nur
authors.initials: N
authors.lastname: Yapar
authors.forename: Husnu
authors.initials: H
authors.lastname: Pullukcu
authors.forename: Vildan
authors.initials: V
authors.lastname: Avkan-Oguz
authors.forename: Selda
authors.initials: S
authors.lastname: Sayin-Kutlu
authors.forename: Bulent
authors.initials: B
authors.lastname: Ertugrul
authors.forename: Suzan
authors.initials: S
authors.lastname: Sacar
authors.forename: Banu
authors.initials: B
authors.lastname: Cetin
authors.forename: Onur
authors.initials: O
authors.lastname: Kaya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida / Q000145:classification* / Q000302:isolation & purification*; D058387:Candidemia / Q000453:epidemiology* / Q000382:microbiology*; D016022:Case-Control Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult