Incidence,risk factors,and predictors of outcome of candidemia. Survey in 2 Italian university hospitals |
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Authors: | Matteo Bassetti Enrico Maria Trecarichi Elda Righi Maurizio Sanguinetti Francesca Bisio Brunella Posteraro Ornella Soro Roberto Cauda Claudio Viscoli Mario Tumbarello |
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Institution: | 1. Division of Infectious Diseases, S. Martino Hospital, University of Genoa School of Medicine, 16132 Genoa, Italy;2. Institute of Infectious Diseases, Catholic University, Roma, Italy;3. Institute of Microbiology, Catholic University, Roma, Italy;4. Institute of Microbiology, University of Genoa School of Medicine, Genoa, Italy |
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Abstract: | In recent decades, Candida spp. emerged as the fourth most common cause of nosocomial bloodstream infections. The incidence of candidemia was 0.13 per 100 persons. Eighty-three cases (61%) of candidemia were due to Candida albicans and 53 (39%) to nonalbicans Candida spp. Twelve strains of Candida (9%) had shown in vitro resistance to fluconazole, 5 (4%) to itraconazole, 2 (1.5%) to voriconazole, 12 (9%) to 5-flucytosine, and 1 (0.7%) to amphotericin B. Multivariate logistic regression analysis of risk factors showed that length of hospitalization, presence of a central venous catheter, previous episodes of candidemia or bacteremia, parenteral nutrition, and chronic renal failure were variables independently associated with the development of candidemia. Multivariate logistic regression analysis of prognostic indicators showed that the independent variables associated with poor prognosis were inadequate initial therapy (P < .001) and high APACHE III score (P = .004). The inadequate initial therapy associated with mortality indicates the need for additional investigations to define high-risk patients for beneficial antifungal prophylaxis. |
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Keywords: | Candidemia Hospital Risk factors Incidence |
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