Epidemiology, Risk Factors, and Prognosis of
Candida parapsilosis
Bloodstream Infections: Case-Control Population-Based Surveillance Study of Patients in Barcelona, Spain, from 2002 to 2003
-
Published:2006-05
Issue:5
Volume:44
Page:1681-1685
-
ISSN:0095-1137
-
Container-title:Journal of Clinical Microbiology
-
language:en
-
Short-container-title:J Clin Microbiol
Author:
Almirante Benito1, Rodríguez Dolors1, Cuenca-Estrella Manuel2, Almela Manel3, Sanchez Ferran4, Ayats Josefina5, Alonso-Tarres Carles6, Rodriguez-Tudela Juan L.2, Pahissa Albert1,
Affiliation:
1. Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain 2. Mycology Department, Instituto de Salud Carlos III, Madrid, Spain 3. Microbiology Department, Hospital Clinic-IDIBAPS, Barcelona, Spain 4. Microbiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain 5. Microbiology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain 6. Microbiology Department, Hospital General de L'Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
Abstract
ABSTRACT
Candida parapsilosis
has emerged as an important yeast species causing fungemia. We describe the incidence and epidemiology of
C. parapsilosis
fungemia. Data from active population-based surveillance in Barcelona, Spain, from January 2002 to December 2003 were analyzed. We focused on 78 episodes of
C. parapsilosis
fungemia, and we compared them with 175
Candida albicans
controls.
C. parapsilosis
accounted for 23% of all fungemias. The annual incidences were 1 episode per 10
5
patients, 1.2 episodes per 10
4
discharges, and 1.7 episodes per 10
5
patient days. All isolates but one (99%) were fluconazole susceptible. Seventy-two isolates (92%) were inpatient candidemias. Forty-two episodes (51%) were considered catheter-related fungemia, 35 (45%) were considered primary fungemia, and 3 (4%) were considered secondary fungemia. Risk factors for candidemia were vascular catheterization (97%), prior antibiotic therapy (91%), parenteral nutrition (54%), prior surgery (46%), prior immunosuppressive therapy (38%), malignancy (27%), prior antifungal infection (26%), transplant recipient (16%), neutropenia (12%), and prior colonization (11%). Multivariate analysis of the differential characteristics showed that the factors that independently predicted the presence of
C. parapsilosis
fungemia were neonate patients (odds ratio [OR], 7.5; 95% confidence interval [CI], 2.1 to 26.8;
P
= 0.002), transplant recipients (OR, 9.2; 95% CI, 1.9 to 43.3;
P
= 0.005), patients with a history of prior antifungal therapy (OR, 5.4; 95% CI, 1.8 to 15.9;
P
= 0.002), and patients who received parenteral nutrition (OR, 2.2; 95% CI, 1.09 to 4.6;
P
= 0.028). The overall mortality rate was lower than that associated with
C. albicans
candidemia (23% versus 43%;
P
< 0.01). In summary,
C. parapsilosis
was responsible for 23% of all candidemias and was more frequent in neonates, in transplant recipients, and in patients who received parenteral nutrition or previous antifungal therapy, mainly fluconazole. The mortality rate was lower than that associated with
C. albicans
fungemia.
Publisher
American Society for Microbiology
Subject
Microbiology (medical)
Reference39 articles.
1. Abi-Said, D., E. Anaissie, O. Uzum, I. Raad, H. Pinzcowski, and S. Vartivarian. 1997. The epidemiology of hematogenous candidiasis caused by different Candida species. Clin. Infect. Dis.24:1122-1128. 2. Epidemiology and Predictors of Mortality in Cases of
Candida
Bloodstream Infection: Results from Population-Based Surveillance, Barcelona, Spain, from 2002 to 2003 3. Baley, J. E., R. M. Kliegman, B. Boxerbaum, and A. A. Fanaroff. 1986. Fungal colonization in the very low birth weight infant. Pediatrics78:225-232. 4. Barchiesi, F., G. Caggiano, L. F. Di Francesco, M. T. Montagna, S. Barbuti, and G. Scalise. 2004. Outbreak of fungaemia due to Candida parapsilosis in a pediatric oncology unit. Diagn. Microbiol. Infect. Dis.49:269-271. 5. Benjamin, D. K., H. Garges, and W. J. Steinbach. 2003. Candida bloodstream infections in neonates. Semin. Perinatol.27:375-383.
Cited by
197 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|