[Candida fungemia]

Schweiz Med Wochenschr. 1989 Sep 9;119(36):1213-8.
[Article in French]

Abstract

From 1980 to 1986, 52 patients presented with an episode of fungemia due to Candida species at the Centre Hospitalier Universitaire Vaudois (representing 2% of the patients with positive blood cultures). In 51 of the 52 patients (98%) the infection was nosocomial, occurring after a median hospital stay of 24 days (range 4-250 days). Only 36 patients (69%) presented with an underlying condition (neoplasms in 18 patients, alcoholism in 7, diabetes in 6, immunosuppressive therapy in 5). In 19 patients (37%) an episode of bacteremia occurred prior to fungemia (median time 14 days, range 1-70 days). Candida albicans was the most commonly isolated species (71%). In 50 patients (96%) the episode of fungemia was associated with a significant, although nonspecific, clinical impairment. The digestive tract (38%) and N intravascular catheter (31%) were the two most common portals of entry for the fungemia. 32 patients (62%) received specific antifungal therapy consisting of amphotericin B in 29 patients (median total dose 450 mg, administered either alone or in association) or of ketoconazole in 3 patients. The global mortality was 46% and the fungemia-related mortality was 21%. Global and fungemia-related mortalities were significantly higher in patients not treated with antifungals than in those treated with them (87% versus 30%, p less than 0.001, and 47% versus 11%, p = 0.01 respectively).

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Amphotericin B / therapeutic use
  • Blood / microbiology
  • Candida albicans / isolation & purification
  • Candidiasis / blood*
  • Candidiasis / drug therapy
  • Candidiasis / etiology
  • Child
  • Child, Preschool
  • Cross Infection / microbiology
  • Female
  • Humans
  • Ketoconazole / therapeutic use
  • Male
  • Middle Aged
  • Retrospective Studies

Substances

  • Amphotericin B
  • Ketoconazole