title: Candidemia among adults in Soweto, South Africa, 1990-2007.
abstract: BACKGROUND
  Studies on candidemia occurring among adults in Southern African are limited. We aimed to document the epidemiology of candidemia among adults in Soweto.
  
  
  METHODS
  This was a retrospective hospital-based study in three discrete periods, involving 9 years, from 1990 to 2007.
  
  
  RESULTS
  Two hundred and sixty-six patients were identified. Case rates were 2.8 cases/10 000 admissions in 1998-2002 and 3.6 episodes/10 000 hospitalizations in 2005-2007. In 1990, Candida albicans caused 62% and Candida tropicalis caused 23% of episodes. In 2005-2007, major species were C. albicans (46%), Candida parapsilosis (25%), and Candida glabrata (23%), with little change compared to 1998-2002. Major predisposing conditions were abdominal surgery (43%), HIV infection (19% in 2005-2007), trauma (16%), diabetes mellitus (12%), and cancer (8%). General wards superseded intensive care as the major diagnostic setting in 2005-2007. The crude mortality was 60%. Among 22 HIV-infected patients with a median CD4 cell count of 68/μl, three were of community-onset. C. albicans caused 73% of cases. Five patients had another predisposing condition and five had central venous catheters. The mortality was 73%.
  
  
  CONCLUSIONS
  Soweto has a pattern of Candida species different from other continents. HIV infection and trauma were important predisposing conditions.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Bertsham, Johannesburg, South Africa.
authors.forename: Adrian
authors.initials: A
authors.lastname: Kreusch
authors.forename: Alan S
authors.initials: AS
authors.lastname: Karstaedt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002176:Candida albicans; D041221:Candida glabrata; D041022:Candida tropicalis; D058387:Candidemia / Q000453:epidemiology* / Q000266:history / Q000401:mortality; D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology; D049673:History, 20th Century; D049674:History, 21st Century; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult