TY - JOUR
T1 - Incidence, risk factors, and predictors of outcome of candidemia. Survey in 2 Italian university hospitals.
AU - Bassetti, M
AU - Trecarichi, Enrico Maria
AU - Righi, E
AU - Sanguinetti, Maurizio
AU - Bisio, F
AU - Posteraro, Brunella
AU - Soro, O
AU - Cauda, Roberto
AU - Viscoli, C
AU - Tumbarello, Mario
PY - 2007
Y1 - 2007
N2 - 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.
AB - 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.
KW - CANDIDEMIA
KW - ITALIAN
KW - OUTCOME
KW - RISK FACTORS
KW - CANDIDEMIA
KW - ITALIAN
KW - OUTCOME
KW - RISK FACTORS
UR - https://publicatt.unicatt.it/handle/10807/12688
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=34347360557&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=34347360557&origin=inward
M3 - Article
SN - 0732-8893
SP - 325
EP - 331
JO - Diagnostic Microbiology and Infectious Disease
JF - Diagnostic Microbiology and Infectious Disease
IS - Luglio
ER -