Candidaemia in an Irish tertiary referral hospital: epidemiology and prognostic factors.

Hdl Handle:
http://hdl.handle.net/10147/208904
Title:
Candidaemia in an Irish tertiary referral hospital: epidemiology and prognostic factors.
Authors:
Boo, T W; O'reilly, B; O'leary, J; Cryan, B
Affiliation:
Department of Microbiology, Cork University Hospital, Cork, Ireland., twboo@eircom.net
Citation:
Mycoses. 2005 Jul;48(4):251-9.
Journal:
Mycoses
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/208904
DOI:
10.1111/j.1439-0507.2005.01134.x
PubMed ID:
15982207
Abstract:
There were two parts to this study. Part 1 evaluated the epidemiology of Candida bloodstream isolates within the Southern Health Board (SHB) of Ireland from 1992 to 2003 by retrospective surveillance of all such isolates of patients reported from SHB hospitals to our laboratory database during that period. Part 2 reviewed candidaemia cases occurring in Cork University Hospital (CUH) from 1999 to 2003 using surveillance of all positive blood culture isolates in CUH microbiology laboratory during the 5-year period. In part 1, 250 Candida bloodstream isolates were reported in the SHB over 12 years. There was a pattern of decreasing percentage of C. albicans with time. Whereas in part 2, 63 cases of candidaemia were identified in CUH from 1999 to 2003. Candida albicans constituted 50% of all isolates, while C. parapsilosis and C. glabrata accounted for 21.2% and 18.2% respectively. Average annual incidence rate was 0.48 episodes/1000 admissions and 0.70 episodes/10 000 patient-days. Vascular catheters were the commonest source of candidaemia (61.9%) followed by the urinary tract (12.7%). Risk factors included exposure to multiple antibiotics (75%); central vascular catheterization (73%); multiple colonization sites (71%); severe gastrointestinal (GI) dysfunction (54%) and acute renal failure (43%). Crude 7-day and 30-day mortality rates were 20.6% and 39.7% respectively. Logistic regression multivariate analysis identified the following to be independent predictors for mortality: age > or =65 years [odds ratio (OR) 7.2, P = 0.013]; severe GI dysfunction (OR 10.6, P = 0.01); acute renal failure (OR 7.6, P = 0.022); recent/concurrent bacteraemia (OR 5.2, P = 0.042); endotracheal intubation (OR 7.7, P = 0.014); while major surgery was associated with a better prognosis (OR 0.05, P = 0.002). Appropriate antifungal treatment was also found to be associated with survival (Fisher's exact test, P < 0.001). The epidemiology of Candida bloodstream isolates within our health board had changed over the years. Incidence and mortality of candidaemia were relatively high in our hospital. Dysfunction of major organ systems and recent bacteraemia were found to predict mortality.
Language:
eng
MeSH:
Adolescent; Adult; Aged; Blood/microbiology; Candida/classification/isolation & purification; Candidiasis/*epidemiology/microbiology; Catheterization; Child; Child, Preschool; Cross Infection/*epidemiology/microbiology; Female; Fungemia/*epidemiology/microbiology; Humans; Incidence; Infant; Infant, Newborn; Ireland/epidemiology; Male; Middle Aged; Prognosis; Retrospective Studies; Risk Factors; Urinary Tract Infections/microbiology
ISSN:
0933-7407 (Print); 0933-7407 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorBoo, T Wen_GB
dc.contributor.authorO'reilly, Ben_GB
dc.contributor.authorO'leary, Jen_GB
dc.contributor.authorCryan, Ben_GB
dc.date.accessioned2012-02-03T15:06:59Z-
dc.date.available2012-02-03T15:06:59Z-
dc.date.issued2012-02-03T15:06:59Z-
dc.identifier.citationMycoses. 2005 Jul;48(4):251-9.en_GB
dc.identifier.issn0933-7407 (Print)en_GB
dc.identifier.issn0933-7407 (Linking)en_GB
dc.identifier.pmid15982207en_GB
dc.identifier.doi10.1111/j.1439-0507.2005.01134.xen_GB
dc.identifier.urihttp://hdl.handle.net/10147/208904-
dc.description.abstractThere were two parts to this study. Part 1 evaluated the epidemiology of Candida bloodstream isolates within the Southern Health Board (SHB) of Ireland from 1992 to 2003 by retrospective surveillance of all such isolates of patients reported from SHB hospitals to our laboratory database during that period. Part 2 reviewed candidaemia cases occurring in Cork University Hospital (CUH) from 1999 to 2003 using surveillance of all positive blood culture isolates in CUH microbiology laboratory during the 5-year period. In part 1, 250 Candida bloodstream isolates were reported in the SHB over 12 years. There was a pattern of decreasing percentage of C. albicans with time. Whereas in part 2, 63 cases of candidaemia were identified in CUH from 1999 to 2003. Candida albicans constituted 50% of all isolates, while C. parapsilosis and C. glabrata accounted for 21.2% and 18.2% respectively. Average annual incidence rate was 0.48 episodes/1000 admissions and 0.70 episodes/10 000 patient-days. Vascular catheters were the commonest source of candidaemia (61.9%) followed by the urinary tract (12.7%). Risk factors included exposure to multiple antibiotics (75%); central vascular catheterization (73%); multiple colonization sites (71%); severe gastrointestinal (GI) dysfunction (54%) and acute renal failure (43%). Crude 7-day and 30-day mortality rates were 20.6% and 39.7% respectively. Logistic regression multivariate analysis identified the following to be independent predictors for mortality: age > or =65 years [odds ratio (OR) 7.2, P = 0.013]; severe GI dysfunction (OR 10.6, P = 0.01); acute renal failure (OR 7.6, P = 0.022); recent/concurrent bacteraemia (OR 5.2, P = 0.042); endotracheal intubation (OR 7.7, P = 0.014); while major surgery was associated with a better prognosis (OR 0.05, P = 0.002). Appropriate antifungal treatment was also found to be associated with survival (Fisher's exact test, P < 0.001). The epidemiology of Candida bloodstream isolates within our health board had changed over the years. Incidence and mortality of candidaemia were relatively high in our hospital. Dysfunction of major organ systems and recent bacteraemia were found to predict mortality.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshBlood/microbiologyen_GB
dc.subject.meshCandida/classification/isolation & purificationen_GB
dc.subject.meshCandidiasis/*epidemiology/microbiologyen_GB
dc.subject.meshCatheterizationen_GB
dc.subject.meshChilden_GB
dc.subject.meshChild, Preschoolen_GB
dc.subject.meshCross Infection/*epidemiology/microbiologyen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshFungemia/*epidemiology/microbiologyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIncidenceen_GB
dc.subject.meshInfanten_GB
dc.subject.meshInfant, Newbornen_GB
dc.subject.meshIreland/epidemiologyen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshPrognosisen_GB
dc.subject.meshRetrospective Studiesen_GB
dc.subject.meshRisk Factorsen_GB
dc.subject.meshUrinary Tract Infections/microbiologyen_GB
dc.titleCandidaemia in an Irish tertiary referral hospital: epidemiology and prognostic factors.en_GB
dc.contributor.departmentDepartment of Microbiology, Cork University Hospital, Cork, Ireland., twboo@eircom.neten_GB
dc.identifier.journalMycosesen_GB
dc.description.provinceMunster-

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