1. [Epidemiology of candidemia: a one-year prospective observational study in the west of France] : Épidémiologie des candidémies : étude observationnelle prospective d'un an dans l'Ouest de la France
- Author
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Talarmin, Jean-Philippe, Boutoille, D., Tattevin, P., Dargère, S., Weinbreck, Pierre, Ansart, S., Chennebault, J.-M., Hutin, P., Léautez-Nainville, S., Gay-Andrieu, F., Raffi, F., Groupe D'Épidémiologie Et De Recherche En Infectiologie Clinique Du Centre-Ouest, Gericco, Service des maladies infectieuses et tropicales [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Unité de Maladies Infectieuses et Tropicales [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service des Maladies infectieuses et tropicales [CHU Limoges], CHU Limoges, Equipe de Recherche Médicale Appliquée (ERMA), Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Université de Limoges (UNILIM)-CHU Limoges, Service de médecine interne 2 et maladies infectieuses, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service des maladies infectieuses et tropicales, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service de médecine générale, interne, infectiologie, maladies du sang, CH Cornouaille, Service de médecine post-urgence, CH La-Roche-Sur-Yon, Laboratoire de parasitologie-mycologie, Service des maladies infectieuses et réanimation médicale [Rennes], Hôpital Pontchaillou-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU), and Université de Limoges (UNILIM)-CHU Limoges-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)
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MESH: Comorbidity ,MESH: Aged, 80 and over ,MESH: Risk Factors ,MESH: Candida ,MESH: Fungemia ,MESH: Postoperative Complications ,MESH: Child ,MESH: Neoplasms ,MESH: Adolescent ,MESH: Aged ,MESH: Catheterization, Central Venous ,MESH: Middle Aged ,MESH: Humans ,MESH: Drug Resistance, Multiple, Fungal ,MESH: Infant, Newborn ,MESH: Child, Preschool ,MESH: Cross Infection ,MESH: Adult ,MESH: Catheter-Related Infections ,MESH: Antifungal Agents ,MESH: Infant ,MESH: Prospective Studies ,MESH: Candidiasis ,MESH: France ,MESH: Superinfection ,MESH: Young Adult ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,MESH: Parenteral Nutrition - Abstract
ERMA; International audience; OBJECTIVE: A one-year prospective, observational study was conducted in the west of France, to evaluate the epidemiology of candidemia. METHOD: During the year 2004, each patient with at least one blood culture yielding Candida sp. was included. For each episode of candidemia, mycological, demographical, clinical, and therapeutic data, as well as outcome, were collected. RESULTS: One hundred and ninety-three strains of Candida sp. were isolated in 186 patients, Candida albicans accounting for 54.9%, Candida glabrata for 18.7%, Candida parapsilosis for 12.9%, Candida tropicalis for 4.7% and Candida krusei for 4.1% of these isolates. A percentage of 84% of the Candida isolates were fully susceptible to fluconazole in vitro. Dose-dependent susceptibility or resistance to fluconazole was detected in more than one third of the Candida glabrata strains, of which 36% were also resistant to voriconazole. Two-thirds of the patients were males, and the mean age was 61.5 years. A percentage of 37% of patients were hospitalized in intensive care units. The main predisposing factors for candidemia were broad-spectrum antibiotics (75.8%), central venous catheter (72.6%), cancer or hematologic malignancy (47.3%), recent surgery (42.5%), total parenteral nutrition (37.6%). One hundred and fifty-four patients were treated with antifungal therapy, two-thirds of whom received fluconazole as first-line agent. Mortality was 49% overall, and was significantly higher in case of septic shock, advanced age, and absence of catheter removal.
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- 2009