Nosocomial Candida parapsilosis candidaemia: risk factors, antifungal susceptibility and outcome.
A retrospective analysis was undertaken from 2000 to 2010 to show the risk factors associated with death within 30 days in patients with C. parapsilosis candidaemia (CPC). Fifty-one cases of nosocomial CPC were included in the analysis. All isolates from blood cultures were susceptible to micafungin and fluconazole. The overall mortality rate was 23.5%, and the most severe complications were endocarditis (5.9%) and endophthalmitis (5.9%). On multi-variate analysis, APACHE II score >25 (odds ratio 43.9) and retained cardiovascular prosthetic materials (RCPM) (prosthetic valve or graft) (odds ratio 14.6) were found to be risk factors associated with death. Prompt surgical removal should be considered in CPC patients with RCPM.
Department of Infectious Diseases, Tokyo Women's Medical University Hospital, Shinjuku-ku, Tokyo, Japan; Department of Haematology, Tokyo Women's Medical University Hospital, Shinjuku-ku, Tokyo, Japan. Electronic address: hirai.yuji@twmu.ac.jp.
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Y
Hirai
Department of Infectious Diseases, Tokyo Women's Medical University Hospital, Shinjuku-ku, Tokyo, Japan.
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Asahata
Department of Infectious Diseases, Tokyo Women's Medical University Hospital, Shinjuku-ku, Tokyo, Japan.
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Y
Ainoda
Laboratory of Microbiology, Tokyo Women's Medical University Hospital, Shinjuku-ku, Tokyo, Japan.
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A
Goto
Department of Infectious Diseases, Tokyo Women's Medical University Hospital, Shinjuku-ku, Tokyo, Japan.
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Fujita
Department of Infectious Diseases, Tokyo Women's Medical University Hospital, Shinjuku-ku, Tokyo, Japan.
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K
Totsuka
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D058387:Candidemia / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
D000935:Antifungal Agents
Candida parapsilosis; Candidaemia; Cardiovascular prosthetic materials; Minimum fungicidal concentration; Minimum inhibitory concentration