[Clinical aspects and prognosis of candidemia, a 6-year retrospective study]

In recent decades an increase in the incidence of fungal infection has been reported. We retrospectively analyzed 41 patients with candidemia seen at Basel University Hospital over a six-year period. 1.2-6.7 candidemias per 10000 admissions were observed. In contrast to other studies, there was no increase during the study period. Out of 41 patients, 19 were hospitalized in ICUs. All patients had risk factors such as intravascular catheters (92.7%), antibiotic therapy (88%), immunosuppressive therapy (31%), indwelling Foley catheters (54%) and previous surgery (63%). The most frequent symptoms were fever with rigor, tachycardia and hypotension. The isolates were Candida albicans (n = 28), Torulopsis glabrata (n = 5), C. krusei (n = 3), C. parapsilosis (n = 2), C. guilliermondii, C. kefyr and C. lusitaniae (n = 1 each). In 22 patients, candida colonization had been documented and 5 patients had superficial mucocutaneous candidiasis before candidemia. The initial foci were the gastrointestinal tract (n = 13), an intravascular catheter (n = 8), the urinary tract (n = 5), the respiratory tract, or intravenous drug use (n = 3 each). Out of 32 patients who were treated either with amphotericin B or fluconazole, 13 died. 5 of the untreated patients died, in 3 instances before microbiological diagnosis. The mortality was similar for treatment with amphotericin B and with fluconazole (50% vs. 33%) (p = 0.3).