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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
- Source :
- Journal of Clinical Microbiology. 44:1681-1685
- Publication Year :
- 2006
- Publisher :
- American Society for Microbiology, 2006.
-
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.
- Subjects :
- Adult
Male
Microbiology (medical)
medicine.medical_specialty
Adolescent
Population
Mycology
Candida parapsilosis
fluids and secretions
Risk Factors
Internal medicine
medicine
Humans
Risk factor
Child
education
Fungemia
Aged
Candida
Aged, 80 and over
education.field_of_study
biology
business.industry
Mortality rate
Incidence (epidemiology)
Candidiasis
Infant, Newborn
Infant
Middle Aged
bacterial infections and mycoses
Prognosis
biology.organism_classification
medicine.disease
Surgery
Spain
Case-Control Studies
Child, Preschool
Population Surveillance
Bacteremia
Female
business
Fluconazole
medicine.drug
Subjects
Details
- ISSN :
- 1098660X and 00951137
- Volume :
- 44
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Microbiology
- Accession number :
- edsair.doi.dedup.....7455fcfdeaed0ff23fa58d82b7df371c