Table 1.
Patient characteristics and incidence (episode/1000 admission)
| Candida species | |||||||
|---|---|---|---|---|---|---|---|
| Total | C. albicans | C. glabrata | C. tropicalis | C. krusei | C. parapsilosis | Othersh | |
| (n = 243) 100.0% |
(n = 110) 45.3% |
(n = 73) 30.0% |
(n = 37) 15.2% |
(n = 12) 4.9% |
(n = 5) 2.1% |
(n = 6) 2.5% |
|
| Patient characteristics | |||||||
| Age (years) | |||||||
| 16–49 | 70 (28.8) | 32 (45.7) | 23 (32.8) | 8 (11.4) | 3 (4.3) | 2 (2.9) | 2 (2.9) |
| 50–65 | 84 (34.6) | 24 (28.6) | 35 (41.6) | 15 (17.9) | 6 (7.1) | 2 (2.4) | 2 (2.4) |
| > 65 | 89 (36.6) | 54 (60.7) | 15 (16.9) | 14 (15.7) | 3 (3.4) | 1 (1.1) | 2 (2.2) |
| Gender | |||||||
| Male | 139 (57.2) | 60 (43.2) | 41 (29.5) | 28 (20.1) | 4 (2.9) | 4 (2.9) | 2 (1.4) |
| Female | 10 4 (42.8) | 50 (48.1) | 32 (30.8) | 9 (8.7) | 8 (7.7) | 1 (0.9) | 4 (3.8) |
| Underlying comorbidities (n, %) | |||||||
| Gastrointestinal perforation | 48 (19.6) | 24 (50.0) | 10 (20.8) | 8 (16.7) | 5 (10.4) | 0 (0) | 1 (2.1) |
| Respiratory dysfunctiona | 51 (21.0) | 25 (49.0) | 16 (31.4) | 9 (17.6) | 0 (0) | 0 (0) | 1 (2.0) |
| Pulmonary infection | 81 (33.3) | 43 (53.1) | 20 (24.7) | 14 (17.3) | 1 (1.2) | 1 (1.2) | 2 (2.5) |
| Cardiovascular disease | 78 (32.1) | 41 (52.6) | 20 (25.6) | 10 (12.8) | 5 (6.4) | 0 (0) | 2 (2.6) |
| Neurological diseases | 58 (23.9) | 35 (60.4) | 10 (17.2) | 9 (15.5) | 2 (3.5) | 1 (1.7) | 1 (1.7) |
| Gastrointestinal pathologyb | 63 (25.9) | 32 (50.8) | 18 (28.6) | 7 (11.1) | 5 (7.9) | 1 (1.6) | 0 (0) |
| Chronic/acute liver disease | 45 (18.5) | 22 (48.9) | 9 (0.2) | 10 (22.2) | 3 (6.7) | 1 (2.2) | 0 (0) |
| Chronic/acute renal failurec | 90 (37.0) | 48 (53.3) | 23 (25.6) | 15 (16.7) | 2 (2.2) | 0 (0) | 2 (2.2) |
| Solid tumour | 22 (9.1) | 11 (50.0) | 2 (9.1) | 7 (31.8) | 2 (9.1) | 0 (0) | 0 (0) |
| Haematological malignancy | 6 (2.5) | 3 (50.0) | 1 (16.7) | 1 (16.7) | 0 (0) | 0 (0) | 1 (16.6) |
| Severe autoimmune diseases | 11 (4.5) | 7 (63.6) | 0 (0) | 3 (27.3) | 1 (9.1) | 0 (0) | 0 (0) |
| Diabetes mellitus | 93 (38.3) | 57 (61.3) | 19 (20.4) | 11 (11.8) | 6 (6.5) | 0 (0) | 0 (0) |
| Burns | 6 (2.5) | 2 (33.3) | 1 (16.7) | 1 (16.7) | 0 (0) | 2 (33.3) | 0 (0) |
| HIV/AIDS | 13 (5.3) | 2 (15.4) | 10 (76.9) | 0 (0) | 0 (0) | 0 (0) | 1 (7.7) |
| Severe trauma | 15 (6.2) | 6 (40.0) | 3 (20.0) | 4 (26.6) | 1 (6.7) | 1 (6.7) | 0 (0) |
| Risk factors (n, %) | |||||||
| Presence of CVCd | 118 (48.6) | 59 (50.0) | 23 (19.5) | 24 (20.3) | 8 (6.8) | 2 (1.7) | 2 (1.7) |
| Mechanical ventilation | 82 (33.7) | 41 (50.0) | 19 (23.2) | 15 (18.3) | 5 (6.1) | 1 (1.2) | 1 (1.2) |
| Receipt of corticosteroidse | 70 (28.8) | 43 (61.4) | 12 (17.1) | 14 (20.0) | 1 (1.4) | 0 (0) | 0 (0) |
| Total parenteral nutrition | 119 (49.0) | 62 (52.1) | 29 (24.4) | 19 (16.0) | 7 (5.9) | 1 (0.8) | 1 (0.8) |
| Chemotherapy | 11 (4.5) | 4 (36.4) | 1 (9.1) | 5 (45.4) | 1 (9.1) | 0 (0) | 0 (0) |
| Abdominal surgeryf | 69 (28.4) | 26 (37.7) | 27 (39.1) | 10 (14.5) | 4 (5.8) | 0 (0) | 2 (2.9) |
| Intensive care in adults | 42 (17.3) | 21 (50.0) | 9 (21.4) | 8 (19.0) | 2 (4.8) | 1 (2.4) | 1 (2.4) |
| Neutropeniag | 7 (2.9) | 4 (57.1) | 0 (0) | 1 (14.3) | 2 (28.6) | 0 (0) | 0 (0) |
| Concomitant bacterial infections | 81 (33.3) | 46 (56.8) | 13 (16.0) | 18 (22.3) | 2 (2.5) | 1 (1.2) | 1 (1.2) |
| Septic shock | 46 (18.9) | 16 (34.8) | 19 (41.4) | 7 (15.2) | 2 (4.3) | 0 (0) | 2 (4.3) |
| Dialysis | 25 (10.3) | 9 (36.0) | 13 (52.0) | 2 (8.0) | 0 (0) | 0 (0) | 1 (4.0) |
| Previous antibiotics therapy | 215 (88.5) | 103 (47.9) | 60 (27.9) | 35 (16.3) | 12 (5.6) | 1 (0.5) | 4 (1.8) |
| Treatment with antifungal agents | 83 (34.2) | 44 (53.0) | 20 (24.1) | 14 (16.9) | 3 (3.6) | 0 (0) | 2 (2.4) |
| Incidence (episodes/1000 admissions) | |||||||
| 2013 | 0.16 | 0.05 | 0.06 | 0.03 | 0.01 | 0 | 0.01 |
| 2014 | 0.31 | 0.16 | 0.07 | 0.06 | 0.01 | 0 | 0.01 |
| 2015 | 0.43 | 0.18 | 0.13 | 0.06 | 0.04 | 0.02 | 0 |
| 2016 | 0.52 | 0.28 | 0.13 | 0.05 | 0.03 | 0 | 0.03 |
| 2017 | 0.66 | 0.25 | 0.23 | 0.12 | 0.02 | 0.03 | 0.01 |
aIncludes the following diseases: chronic obstructive pulmonary disease and acute respiratory distress syndrome
bIncludes the following diseases: cholecystitis, pancreatitis, and peritonitis
cChronic/Acute renal failure is the permanent or sudden and often temporary loss of kidney function with N waste retention and hypourocrinia
dCVC central venous catheter
ea dose equivalent to the prednisone dosage of 0.3 mg/kg/day for at least 14 days
fincluding: gastrointestinal perforations, severe acute pancreatitis and complex ventral hernia
gNeutropenia is the absolute neutrophil count, that is, < 500 cells/μl
hOthers include C. guilliermondii (3), C. haemulonii (2) and C. pseudotropicalis (1)