title: [Candidemias: multicentre analysis in 16 hospitals in Andalusia (Spain)].
abstract: BACKGROUND
  Candidemia is a nosocomial infection with high associated mortality. There have been changes in microbiology, epidemiology and treatment over the last few years, which has led us to analyse our own situation.
  
  
  METHODS
  Prospective, multicentre and observational study. All episodes of candidemia in adult patients seen in 17 Andalusian hospitals from 1 October 2005 to 30 September 2006 were included.
  
  
  RESULTS
  Were detected 220 cases, the incidence was 0.58 cases/1,000 hospital discharges. Candida albicans was the most frecuent species (53% of cases). The majority of isolates (89%) was susceptibility to fluconazole. Sepsis was the most frequent clinical manifestation (65.7%). The treatment was inadequate in 38.7% of cases. Overall mortality was 40%. On univarite analysis death was found to be significantly associated with: aged > 60 years, unknown candidemia focus, Pitt score ≥ 2, APACHE II, shock at onset, persistents positive second blood cultures, non-removal of the central venous catheter and Candida species different of C. parasilopsis, among others. In the multivariate analysis death was found to be significantly associated with: aged > 60 years, Pitt score ≥ 2, Candida species different of C.parasilopsis and inadequate treatment.
  
  
  CONCLUSIONS
  The candidemia clinical epidemiology in our region is similar to other areas and receiving inadequate treatment is the only modifiable risk factor associated with higher odds of mortality. Therefore, this modifiable factor needs to be improved to reduce the mortality.
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: M Jesús
authors.initials: MJ
authors.lastname: Rodríguez-Hernández
authors.forename: Maite
authors.initials: M
authors.lastname: Ruiz-Pérez de Pipaon
authors.forename: Manuel
authors.initials: M
authors.lastname: Márquez-Solero
authors.forename: Patricia
authors.initials: P
authors.lastname: Martín-Rico
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Castón-Osorio
authors.forename: Francisca M
authors.initials: FM
authors.lastname: Guerrero-Sánchez
authors.forename: Elisa
authors.initials: E
authors.lastname: Vidal-Verdú
authors.forename: Carolina
authors.initials: C
authors.lastname: García-Figueras
authors.forename: Alfonso
authors.initials: A
authors.lastname: Del Arco-Jiménez
authors.forename: Jesús
authors.initials: J
authors.lastname: Rodríguez-Baño
authors.forename: Estrella
authors.initials: E
authors.lastname: Martín-Mazuelos
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Cisneros-Herreros
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058387:Candidemia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011446:Prospective Studies; D013030:Spain; D055815:Young Adult