Candidemia at a Tertiary-Care Hospital: Epidemiology, Treatment, Clinical Outcome and Risk Factors for Death

Viudes, A; Pemán, Javier; Cantón, Emilia; Ubeda, P; López-Ribot, José L.; Gobernado, M

doi:10.1007/s10096-002-0822-1

Cited by 221 publications

(185 citation statements)

References 69 publications

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“…In this study, the majority of the diagnosed cases of fungemia had Candida species as the main agent, and such results are similar to the findings of other studies, suggesting this genus as primarily responsible for cases of fungemia in immunossupressed patients 2,15 .…”

Section: Discussionsupporting

confidence: 81%

“…The clinical presentation is nonspecific, and fever is the most common one 2,6 , which makes the diagnosis of fungemia a challenge, as blood cultures are positive in less than 50% of cases 6,7 . Thus, the diagnosis is usually late in the course of the infection or even during necropsy 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Among these infections, fungemia corresponds to the presence of fungi in the bloodstream, whose incidence has risen in recent decades. The presence of viable microorganisms in the bloodstream suggests active infection in tissues, and the patient's recovery may depend on early identification and isolation of the aethiological agent 2,3 .…”

Section: Introductionmentioning

confidence: 99%

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Fungemia in a university hospital: an epidemiological approach

Couto

Macedo

Neves

2011

Rev. Soc. Bras. Med. Trop.

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Introduction: Fungemia corresponds to the isolation of fungi in the bloodstream and occurs mostly in immunosuppressed patients. The early diagnosis and treatment of these infections are relevant given the serious threat to the affected patients and possible spread to other organs, often becoming fatal. The growing number of fungemia associated with poor prognosis resulted in this research aiming to diagnose and assess the epidemiological aspects of hematogenous infections by fungi. Methods: The study included 58 blood samples collected within a 1-year period, from patients at the Hospital das Clinicas, Federal University of Pernambuco, by venipuncture in vacuum tubes. Blood samples were processed for direct examination and culture and identification, conducted by observing the macroscopic and microscopic characteristics, as well as physiological characteristics when necessary. Results: Eight (13.8%) episodes of fungemia were identified, accounting for the total sample, and these pathogens were Candida, Histoplasma, Trichosporon, Cryptococcus, and a dematiaceous fungus. C. albicans was the prevalent species, accounting for 37.5% of the cases. Most affected patients were adult males. There was no predominance for any activity, and the risk of acquired immunodeficiency syndrome was the underlying pathology most often cited. Conclusions: The isolation of fungi considered as emergent species, such as C. membranifaciens and dematiaceous species, highlights the importance of epidemiological monitoring of cases of fungemia in immunocompromised patients, as the therapy of choice depends on the knowledge of the aethiological agent.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

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Fungemia in a university hospital: an epidemiological approach

Couto

Macedo

Neves

2011

Rev. Soc. Bras. Med. Trop.

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“…Candidemia was regarded as the primary cause of death (attributable mortality) when a patient died with microbiological and histological or clinical evidence of fungal infection with no other cause identified [17].…”

Section: Case Definitionsmentioning

confidence: 99%

Characteristics and risk factors of candidemia in pediatric intensive care unit of a tertiary care children's hospital in Egypt

Hegazi

Abdelkader

Zaki

et al. 2014

J Infect Dev Ctries

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Introduction: This study was conducted to determine characteristics of Candida colonization and candidemia in the pediatric intensive care unit (PICU) of a tertiary care children's hospital. Methodology: Patients between 6 months and 15 years of age consecutively admitted to the PICU of Mansoura University Children's Hospital in Mansoura, Egypt, during one year period, were evaluated for Candida colonization and candidemia. Susceptibility of Candida species isolated from blood to fluconazole and amphotericin B was determined by Etest. Results: Sixty-six patients without prior fluconazole prophylaxis had 88 episodes of candidemia, representing 19% of all cases with blood stream infections (BSIs). Candida albicans (CA) and non-albicans Candida (NAC) species accounted for 40% and 60% of candidemia episodes respectively. C. parapsilosis, C. tropicalis, and C. glabrata accounted for 25%, 17%, and 8% of NAC candidemias respectively. Fluconazole resistance was detected in 11.4% and 18.9% of CA and NAC isolates respectively. Of the fluconazole resistant NAC isolates, four were C. krusei. Amphotericin B resistance was detected in 17% of NAC isolates. Candida colonization was detected in 78.8% of patients. Compared to CA candidemia, higher risk for NAC candidemia was associated with age older than 1 year, Candida isolation from endotracheal tube (ETT) and from central venous catheter. Mortality rate was 42.4%, attributable mortality of candidemia was 16.7%. Regression analysis showed that the most significant independent predictors of death were ETT and mechanical ventilation (MV), MV longer than 7 days, and candiduria. Conclusions: This study presents important epidemiological features of Candida BSIs in a non-neonatal population.

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“…Así, las candidemias causadas por especies resistentes a triazoles (C. krusei o C. glabrata) tienen un peor pronóstico que aquellas originadas por especies sensibles (29,33), entre las cuales se ha reportado que C. parasilopsis causa las infecciones con la evolución clínica más favorable (29,34).…”

Section: Guillermondii 244pbunclassified

A new multiplex PCR for species-specific diagnosis of human candidiasis

et al. 2017

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Introducción. Las candidiasis son un grupo de infecciones oportunistas causadas por levaduras del género Candida. C. albicans es la especie de mayor prevalencia en infecciones superficiales y profundas, sin embargo en la actualidad la frecuencia de especies no albicans, ha incrementado considerablemente su relevancia clínica en la última década, haciendo obligatoria la utilización de técnicas diagnósticas que permitan la identificación de especies para el manejo terapéutico adecuado de los pacientes.Objetivo. Diseñar y optimizar una técnica de PCR múltiplex considerando parámetros termodinámicos, para la identificación simultánea de cinco especies de Candida relevantes en la etiología de candidiasis humana.Materiales y métodos. Para el diseño de los cebadores se consideraron restricciones físicas y termodinámicas que afectan la PCR múltiplex, usando Gene Runner y Mult-PSOS. Como secuencias base se utilizaron: región transcrita interna 2 (ITS2) (AJ249486.1) para C. albicans y topoisomerasa II (TOPII) para C. parasilopsis (AB049144.1), C. krusei (AB049139.1), C. tropicalis (AB049141.1) y C. guillermondii (AB049145.1). Como moldes fueron utilizados extractos de ADN total obtenidos de cepas ATCC y aislamientos clínicos de las especies de Candida.Resultados. Se diseñaron 10 cebadores para la amplificación simultánea de las especies de Candida. El patrón de bandas obtenido fue: C. albicans (206pb), C. guillermondii (244pb), C. tropicalis (474pb), C. parasilopsis (558pb) y C. krusei (419pb).Conclusión. El ensayo de PCR múltiplex diseñado permitió la amplificación simultánea y eficiente de todos los amplicones correspondientes a las especies de Candida estudiadas, las cuales presentaron una adecuada resolución en gel de agarosa al 1,3%.

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Candidemia at a Tertiary-Care Hospital: Epidemiology, Treatment, Clinical Outcome and Risk Factors for Death

Cited by 221 publications

References 69 publications

Fungemia in a university hospital: an epidemiological approach

Fungemia in a university hospital: an epidemiological approach

Characteristics and risk factors of candidemia in pediatric intensive care unit of a tertiary care children's hospital in Egypt

A new multiplex PCR for species-specific diagnosis of human candidiasis

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