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Candidaemia Observed at a University Hospital in Milan (Northern Italy) and Review of Published Studies from 2010 to 2014

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Abstract

Background

Candida species represent the fourth leading cause of nosocomial bloodstream infections (BSI) worldwide. However, candidaemia rates and species involved vary geographically.

Objectives

To evaluate the epidemiological pattern, risk factors for mortality and antifungal therapy of Candida BSI over a 5-year period (2008–2012) in a university hospital in northern Italy together with a review of the recent literature concerning candidaemia.

Methods

A retrospective cohort study cross-linked with microbiology database was performed.

Results

A total of 89 Candida BSI were identified in 42 males (47 %) and 47 females (52.8 %). The median age was 69 years (interquartile range 55–78) with 61.8 % of patients being older than 65 years. Considering all hospitalized patients, the overall incidence rate of candidaemia increased significantly from 2008 to 2012 (from 0.4 to 1.68 episodes per 10,000 patient/days) (p = 0.0001) with a mean linear increase in 5 new cases per year. Candida albicans was the predominant species isolated (64 %) followed by C. glabrata (19.1 %). The latter species was observed with significantly higher frequency in Internal Medicine and Intensive Care Units (ICU). In-hospital crude mortality was 41.6 %.

Conclusions

Candidaemia is an increasing BSI in our university hospital, in accordance with that observed in northern Italy, and it is still associated with high in-hospital crude mortality.

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Acknowledgments

We are grateful to Mrs. Enza Pallone for careful patients’ records selection from the in-hospital database.

Conflict of interest

This study was not supported by any fund, and no conflicts of interest exist for any of the authors.

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Authors and Affiliations

  1. III Division of Infectious Diseases, Department of Biomedical and Clinical Sciences L. Sacco, Luigi Sacco Hospital, University of Milan, Via G.B. Grassi 74, 20157, Milan, Italy

    Laura Milazzo, Anna Maria Peri, Chiara Cazzani, Davide Ricaboni, Massimo Galli & Spinello Antinori

  2. Section of Biostatistics, Department of Clinical Sciences, University of Milan, Milan, Italy

    Cristina Mazzali

  3. Clinical Microbiology, Virology and Bioemergence Diagnostics, Luigi Sacco Hospital, Milan, Italy

    Romualdo Grande

  4. Intensive Care Unit, Luigi Sacco Hospital, Milan, Italy

    Antonio Castelli & Ferdinando Raimondi

  5. I Division of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy

    Carlo Magni

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  1. Laura Milazzo
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Correspondence to Laura Milazzo.

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Milazzo, L., Peri, A.M., Mazzali, C. et al. Candidaemia Observed at a University Hospital in Milan (Northern Italy) and Review of Published Studies from 2010 to 2014. Mycopathologia 178, 227–241 (2014). https://doi.org/10.1007/s11046-014-9786-9

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