Risk factors,clinical presentation and prognosis of mixed candidaemia: a population‐based surveillance in Spain |
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| Authors: | Antonio Ramos Yolanda Romero Isabel Sánchez‐Romero Jesús Fortún José Ramón Paño Javier Pemán Mercè Gurguí Jesús Rodríguez‐Baño Belén Padilla |
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| Affiliation: | 1. Infectious Diseases Unit (MI), Hospital Universitario Puerta de Hierro, Majadahonda, Spain;2. Spanish Network for Research in Infectious Diseases (REIPI), Madrid, Spain;3. Internal Medicine Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain;4. Microbiology Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain;5. Infectious Diseases Department, Hospital Universitario Ramón y Cajal, Madrid, Spain;6. Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Spain;7. Microbiology Department, Hospital Universitario la Fe, Valencia, Spain;8. Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau and Instituto de Investigación Biomédica Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain;9. Infectious Diseases Department, Hospital Universitario Virgen Macarena, Seville, Spain;10. Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Mara?ón, Madrid, Spain |
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| 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. |
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| Keywords: | Candidaemia mortality
Candida krusei
HIV
burns central venous catheters |
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