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Epidemiology, clinical characteristics, and outcome of candidemia in a tertiary referral center in Italy from 2010 to 2014

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Abstract

Purpose

We evaluated the epidemiology, clinical characteristics and outcome of candidemia in a single institution from 2010 to 2014.

Methods

A retrospective observational study of all cases of candidemia was carried out at a University Hospital in Central Italy including five intensive care units (ICUs), 11 medical and 11 surgical wards. Data regarding demographic characteristics and clinical risk factors were collected from the patient’s medical records. Antifungal susceptibility testing was performed and MIC results were interpreted according to species-specific clinical breakpoints.

Results

A total of 270 episodes of candidemia were identified. Overall incidence rate was 1.5 episodes/1000 hospital admissions. Although Candida albicans represented the most commonly isolated species, its percentage significantly decreased from 68 to 48 % (p = 0.040). The overall 30-day mortality was 35 %. The variables independently associated with a significant higher risk of mortality were: older age; being hospitalized in ICU or in medical wards vs surgical wards; being infected with C. albicans vs other species; the occurrence of septic shock, pneumonia and acute renal failure; the presence of a solid organ tumor or a chronic pulmonary disease. Conversely, an appropriate treatment was confirmed to be significantly associated with a lower risk of mortality. The overall resistance was low and it was noted only among triazoles.

Conclusions

Our study shows that candidemia is a significant source of morbidity and mortality. The identification of risk factors associated with mortality along with the knowledge of local susceptibility may lead to a better management in terms of preventive and therapeutic measures.

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Acknowledgments

Candidemia Study Group Azienda Ospedaliera-Universitaria Umberto I°-Lancisi-Salesi, Ancona, Italy: E.C. Amadi, E. Balestra, F. Barchiesi, A. Benedetti, M. Bernardini, A. Carbonari, V.P. Carnielli, S. Cascinu, A. Catassi, F.M. De Benedictis, A. Falconi, G.M. Frascà, A. Gabrielli, A. Giacometti, M. Guerrieri, P. Leoni, E. Manso, S. Mazzanti, P. Mosca, C. Munch, G. Muzzonigro, A. Napolitano, A. Nicolai, C. Nitti, E. Orsetti, P. Osimani, P. Pelaia, G.P. Perna, P. Pierani, L. Provinciali, S. Punzo, M. Riccio, A. Sabbatini, A. Salvi, F. Santinelli, M. Scerrati, M. Tavio, L. Torracca, M. Vivarelli.

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Authors and Affiliations

  1. Dipartimento di Scienze Biomediche e Sanità Pubblica, Clinica Malattie Infettive, Università Politecnica delle Marche, Ancona, Italy

    Francesco Barchiesi & Elena Orsetti

  2. Dipartimento di Scienze Biomediche e Sanità Pubblica, Centro di Epidemiologia e Biostatistica, Università Politecnica delle Marche, Ancona, Italy

    Rosaria Gesuita & Edlira Skrami

  3. Laboratorio di Microbiologia, Azienda Ospedaliera-Universitaria Umberto I°-Lancisi-Salesi, Ancona, Italy

    Esther Manso

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  1. Francesco Barchiesi
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The Candidemia Study Group

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Correspondence to Francesco Barchiesi.

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All authors declare no potential conflicts of interest regarding their contribution to this study.

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Candidemia Study Group members listed in the Acknowledgments section.

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Barchiesi, F., Orsetti, E., Gesuita, R. et al. Epidemiology, clinical characteristics, and outcome of candidemia in a tertiary referral center in Italy from 2010 to 2014. Infection 44, 205–213 (2016). https://doi.org/10.1007/s15010-015-0845-z

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  • DOI: https://doi.org/10.1007/s15010-015-0845-z

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