Incidence, etiology and risk factors associated with mortality of nosocomial candidemia in a tertiary care hospital in Istanbul, Turkey.
OBJECTIVE
The aim of this study was to determine the incidence, etiology and risk factors for mortality of patients with nosocomial candidemia.


METHODS
This observational study was performed at Haydarpasa Numune Training and Research Hospital, a tertiary care hospital with 750 beds, between the years 2004 and 2007. Fifty defined cases with a nosocomial bloodstream infection caused by Candida species were included in the study. All demographic, microbiological and clinical records for each patient were collected using a standardized form. Blood culture was performed by automated blood culture system, and those samples positive for yeast were subcultured on Sabouraud agar.


RESULTS
The mean incidence density of nosocomial candidemia was 0.58/10,000 patient-days/year (range 0.17-1.4). Candidemia episodes increased from 0.17/10,000 to 1.4/10,000 patient-days/year (p < 0.0001). Candida albicans and non-albicans Candida accounted for 15 (30%) and 35 (70%) cases, respectively. The overall mortality was 56% and was significantly associated with stayingin the intensive care unit (odds ratio: 3.667, 95% confidence interval: 1.07-12.54, p = 0.034).


CONCLUSIONS
This study showed that there was a significantly increased trend in the incidence of candidemia with high mortality during the study period.
Erdem
Ilknur
I
Clinic of Infectious Disease, Haydarpasa Numune Hospital, Istanbul, Turkey. ierdem@nku.edu.tr
Oguzoglu
Naz
N
Ozturk Engin
Derya
D
Ozgultekin
Asu
A
Inan
Asuman Sengoz
AS
Ceran
Nurgul
N
Kaya
Fatma
F
Genc
Ipek
I
Goktas
Pasa
P
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D058387:Candidemia / Q000453:epidemiology* / Q000401:mortality; D003428:Cross Infection / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006746:Hospital Bed Capacity, 500 and over; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult