Epidemiology, clinical characteristics, and outcome of candidemia: experience in a tertiary referral center in the UK

Int J Infect Dis. 2011 Nov;15(11):e759-63. doi: 10.1016/j.ijid.2011.06.006. Epub 2011 Aug 15.

Abstract

Objectives: To review the epidemiology of candidemia in a UK tertiary referral center.

Methods: Clinical and laboratory data from patients with candidemia were collected prospectively from October 1, 2005 to June 30, 2008 (a 33-month period).

Results: A total of 107 episodes were identified. The incidence was 10.9 episodes/100 000 bed-days. The most common predisposing factors were the use of broad-spectrum antibiotics (92%), the presence of an intravascular device (IVD) (82%), admission to an intensive care unit (ICU) (51%), and recent surgery (50%). Non-Candida albicans species accounted for 58% of the episodes, which is higher than the percentage reported from other UK centers. C. albicans was the most common species, accounting for 43% of episodes, followed by C. glabrata (31%) and C. parapsilosis (20%). Overall C. tropicalis, C. krusei, C. norvegensis, and C. lusitaniae caused 7% of episodes. The crude 30-day mortality rate was 37%. Advanced age (p = 0.003) and the presence of septic shock (p = 0.038) were associated with mortality.

Conclusions: Candidemia continues to be associated with a high mortality. Preventative measures should be targeted against high-risk hospitalized patients, especially those in ICUs, the elderly, and those undergoing major surgery. Local surveillance of candidemia is important to optimize management.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antifungal Agents / therapeutic use*
  • Candida / drug effects
  • Candida / isolation & purification*
  • Candida albicans / drug effects
  • Candida albicans / isolation & purification*
  • Candidemia / epidemiology*
  • Candidemia / microbiology
  • Candidemia / mortality
  • Female
  • Hospitals
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prospective Studies
  • Referral and Consultation
  • Risk Factors
  • Shock, Septic / epidemiology*
  • Shock, Septic / microbiology
  • Shock, Septic / mortality
  • United Kingdom / epidemiology
  • Young Adult

Substances

  • Antifungal Agents