Authors: S CostadeOliveira C PinaVaz D Mendonça A Gonçalves Rodrigues
Publish Date: 2008/01/19
Volume: 27, Issue: 5, Pages: 365-374
Abstract
A prospective observational study was conducted at the biggest Portuguese hospital aiming to evaluate the epidemiology of bloodstream fungal infection During a period of 12 months 2004 all yeasts isolated from the blood cultures of patients with fungaemia admitted at a university hospital of Porto were collected Demographic and clinical data as well as haematological and biochemical profiles were registered Antifungal susceptibility was evaluated The incidence of fungaemia and nosocomial fungaemia were 27 and 2 per 1000 hospital admissions respectively Blood strains from 117 patients were identified Thirtyfive percent of yeast isolates were Candida albicans followed by C parapsilosis 256 The mortality rate associated with fungaemia was 393 the highest values were found in patients with C glabrata and C tropicalis infection Seventyfive percent of the fungaemia episodes were nosocomial with 48 mortality the main predisposing factors were parenteral nutrition gastric protection with omeprazole surgical drainage and the presence of central venous catheters CVCs Thrombocytopaenia urinary catheter gastrointestinal pathology and nosocomial fungaemia were independently associated with a poor outcome Antifungal susceptibility testing showed high fluconazole resistance 15 mostly in C tropicalis We observed a high incidence of nosocomial fungaemia with high mortality rates Important predisposing factors were identified deserving further investigation Local surveillance is warranted to monitor the incidence of in vitro antifungal resistance
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