Nosocomial candidemia in non-neutropenic patients at an Italian tertiary care hospital

R. Luzzati, G. Amalfitano, L. Lazzarini, F. Soldani, S. Bellino, M. Solbiati, M. C. Danzi, S. Vento, G. Todeschini, C. Vivenza, E. Concia

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Abstract

In a retrospective study conducted in an Italian tertiary care hospital, the incidence of nosocomial candidemia was evaluated together with causative pathogens, treatment, and risk factors for death. Over a 6-year period (1992-1997), a total of 189 episodes of candidemia occurred in 189 patients (mean age 58±19 years), accounting for an average incidence of 1.14 episodes per 10,000 patient-days per year. The most common reasons for hospitalization were solid neoplasia (21%), trauma (17%), abdominal diseases requiring surgery (13%), and cardiovascular diseases (13%). No patient was neutropenic within 3 weeks prior to the onset of candidemia. One hundred thirty patients were hospitalized in intensive care units, 47 patients in surgical wards, and 12 patients in medical wards. Candida albicans was the most frequently isolated pathogen, accounting for 54% of fungal isolates, followed by Candida parapsilosis (23%), Candida glabrata (7%), Candida tropicalis (5%), Candida pelliculosa (4%), Candida lusitaniae (1%), Candida humicula (1%), and other non-albicans Candida spp. (5%). Seventy-six (41%) patients received adequate antifungal therapy. Seventy-one (58%) of the 123 evaluable patients with central venous catheters underwent line removal; 51 of them had catheter-related candidemia. The 30-day crude mortality rate was 45%. Older age, hospitalization in an intensive care unit, a longer duration of candidemia, retention of central lines, and inadequate antifungal therapy were significantly associated with poor outcome. In the present study, nosocomial candidemia was a frequent and relatively underestimated illness. Adequate antifungal therapy and central line removal independently reduced the high mortality of the disease.

Original languageEnglish
Pages (from-to)602-607
Number of pages6
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Volume19
Issue number8
Publication statusPublished - 2000
Externally publishedYes

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Candidemia
Tertiary Healthcare
Tertiary Care Centers
Candida
Intensive Care Units
Hospitalization
Candida tropicalis
Candida glabrata
Central Venous Catheters
Mortality
Incidence
Therapeutics
Candida albicans
Cardiovascular Diseases
Catheters
Retrospective Studies

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Luzzati, R., Amalfitano, G., Lazzarini, L., Soldani, F., Bellino, S., Solbiati, M., ... Concia, E. (2000). Nosocomial candidemia in non-neutropenic patients at an Italian tertiary care hospital. European Journal of Clinical Microbiology and Infectious Diseases, 19(8), 602-607.

Nosocomial candidemia in non-neutropenic patients at an Italian tertiary care hospital. / Luzzati, R.; Amalfitano, G.; Lazzarini, L.; Soldani, F.; Bellino, S.; Solbiati, M.; Danzi, M. C.; Vento, S.; Todeschini, G.; Vivenza, C.; Concia, E.

In: European Journal of Clinical Microbiology and Infectious Diseases, Vol. 19, No. 8, 2000, p. 602-607.

Research output: Contribution to journalArticle

Luzzati, R, Amalfitano, G, Lazzarini, L, Soldani, F, Bellino, S, Solbiati, M, Danzi, MC, Vento, S, Todeschini, G, Vivenza, C & Concia, E 2000, 'Nosocomial candidemia in non-neutropenic patients at an Italian tertiary care hospital', European Journal of Clinical Microbiology and Infectious Diseases, vol. 19, no. 8, pp. 602-607.
Luzzati R, Amalfitano G, Lazzarini L, Soldani F, Bellino S, Solbiati M et al. Nosocomial candidemia in non-neutropenic patients at an Italian tertiary care hospital. European Journal of Clinical Microbiology and Infectious Diseases. 2000;19(8):602-607.
Luzzati, R. ; Amalfitano, G. ; Lazzarini, L. ; Soldani, F. ; Bellino, S. ; Solbiati, M. ; Danzi, M. C. ; Vento, S. ; Todeschini, G. ; Vivenza, C. ; Concia, E. / Nosocomial candidemia in non-neutropenic patients at an Italian tertiary care hospital. In: European Journal of Clinical Microbiology and Infectious Diseases. 2000 ; Vol. 19, No. 8. pp. 602-607.
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