title: Epidemiology, clinical characteristics, and outcome of candidemia: experience in a tertiary referral center in the UK.
abstract: OBJECTIVE
  To review the epidemiology of candidemia in a UK tertiary referral center.
  
  
  METHODS
  Clinical and laboratory data from patients with candidemia were collected prospectively from October 1, 2005 to June 30, 2008 (a 33-month period).
  
  
  RESULTS
  A total of 107 episodes were identified. The incidence was 10.9 episodes/100 000 bed-days. The most common predisposing factors were the use of broad-spectrum antibiotics (92%), the presence of an intravascular device (IVD) (82%), admission to an intensive care unit (ICU) (51%), and recent surgery (50%). Non-Candida albicans species accounted for 58% of the episodes, which is higher than the percentage reported from other UK centers. C. albicans was the most common species, accounting for 43% of episodes, followed by C. glabrata (31%) and C. parapsilosis (20%). Overall C. tropicalis, C. krusei, C. norvegensis, and C. lusitaniae caused 7% of episodes. The crude 30-day mortality rate was 37%. Advanced age (p = 0.003) and the presence of septic shock (p = 0.038) were associated with mortality.
  
  
  CONCLUSIONS
  Candidemia continues to be associated with a high mortality. Preventative measures should be targeted against high-risk hospitalized patients, especially those in ICUs, the elderly, and those undergoing major surgery. Local surveillance of candidemia is important to optimize management.
authors.affiliation: Department of Clinical Microbiology and Infection Control, University Hospitals Birmingham NHS Foundation Trust, Birmingham B152TH, UK. ira.das@uhb.nhs.uk
authors.forename: I
authors.initials: I
authors.lastname: Das
authors.forename: P
authors.initials: P
authors.lastname: Nightingale
authors.forename: M
authors.initials: M
authors.lastname: Patel
authors.forename: P
authors.initials: P
authors.lastname: Jumaa
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use*; D002175:Candida / Q000187:drug effects / Q000302:isolation & purification*; D002176:Candida albicans / Q000187:drug effects / Q000302:isolation & purification*; D058387:Candidemia / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D005260:Female; D006761:Hospitals; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012017:Referral and Consultation; D012307:Risk Factors; D012772:Shock, Septic / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000935:Antifungal Agents