title: Risk factors, clinical presentation and prognosis of mixed candidaemia: a population-based surveillance in Spain.
abstract: The low incidence of mixed candidaemia (MC) may have precluded a better knowledge of its clinical presentation. The aim of the study was to analyse the risk factors, clinical presentation and prognosis of MC episodes. A comparison between MC and monomicrobial candidaemia within a prospective programme on candidaemia was performed in 29 hospitals between April 2010 and May 2011. In fifteen episodes of candidaemia corresponding to 15 patients, out of 752, two species of Candida (1.9%) were isolated. MC was more frequent in patients with HIV infection (12%, P = 0.038) and those admitted due to extensive burns (23%, P = 0.012). The Candida species most frequently identified in MC were C. albicans 12 patients (40%), C. glabrata seven patients (23.3%) and C. parapsilosis six patients (20%). Early mortality was higher (nine patients, 60%) in patients with MC than in patients with MMC (223 patients, 30.3%, P = 0.046). In conclusion, MC was was independently associated with increased mortality even after considering other prognostic factors. MC is an infrequent event that is more common in HIV infection and in patients suffering from burns, and is associated with increased mortality.
authors.affiliation: Infectious Diseases Unit (MI), Hospital Universitario Puerta de Hierro, Majadahonda, Spain. aramos220@gmail.com.|Spanish Network for Research in Infectious Diseases (REIPI), Madrid, Spain. aramos220@gmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ramos
authors.affiliation: Internal Medicine Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Romero
authors.affiliation: Microbiology Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Sánchez-Romero
authors.affiliation: Infectious Diseases Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Fortún
authors.affiliation: Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Paño
authors.affiliation: Microbiology Department, Hospital Universitario la Fe, Valencia, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Pemán
authors.affiliation: Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau and Instituto de Investigación Biomédica Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Mercè
authors.initials: M
authors.lastname: Gurguí
authors.affiliation: Infectious Diseases Department, Hospital Universitario Virgen Macarena, Seville, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Rodríguez-Baño
authors.affiliation: Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Padilla
mesh_terms: D000328:Adult; D000368:Aged; D002056:Burns / Q000453:epidemiology / Q000382:microbiology; D002175:Candida / Q000302:isolation & purification; D002176:Candida albicans / Q000302:isolation & purification; D041221:Candida glabrata / Q000302:isolation & purification; D058387:Candidemia / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D060085:Coinfection / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000821:virology; D003428:Cross Infection / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000821:virology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
keywords: Candida krusei; Candidaemia; HIV; burns; central venous catheters; mortality