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Cited by 831Antifungal resistance and susceptibilityInfection Control in HealthcareNosocomial Infections in ICU

Hospital-Acquired Candidemia: The Attributable Mortality and Excess Length of Stay

Wey, Sergio B.·1988·Archives of Internal Medicine
DOI 10.1001/archinte.1988.00380120094019
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Abstract

Between 1977 and 1984, estimates of hospital-acquired bloodstream infections caused by Candida species increased in the United States from 0.5 to 1.5 per 10,000 admissions (National Nosocomial Infection Study data). We examined crude and attributable mortality rates and excess length of stay in 88 closely matched pairs of cases and controls with illnesses occurring between July 1983 and December 1986. The crude mortality rates for cases and controls were 57% and 19%, respectively; thus the attributable mortality rate was 38% with a 95% confidence interval of 26% to 49%. The risk ratio was 2.94 with a 95% confidence interval of 1.95 to 4.43. The median length of stay was 48 days for all cases and 40 days for all controls. An analysis of the length of stay for the 34 matched pairs that survived showed a median of 70 days for cases and 40 days for controls. Candida bloodstream infections represented 10% of all nosocomial bloodstream infections in the period studied at our University Hospital; they are associated with a significant medical and economic burden well above that expected of the underlying diseases alone.

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Crossref · 10.1001/archinte.1988.00380120094019

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  • Normally rare fungi such as Candida spp bloom in the gut of critically ill patients, and culture-based detection of candidaemia is a marker of disease severity and predictive of a poor outcome.

    “normally rare fungi, such as Candida spp, bloom and thrive;20 culture-based detection of candidaemia is a marker of disease severity and predictive of a poor outcome.”

    From The microbiome and critical illness (2016) · cites this paper as [72]

  • Candida bloodstream infections are often associated with clinical evidence of sepsis syndrome and high associated attributable mortality.

    “Candida bloodstream infections are increasingly frequent [101,102] and are often associated with clinical evidence of sepsis syndrome and high associated attributable mortality [103, 104].”

    From Guidelines for Treatment of Candidiasis (2004) · cites this paper as [104]

  • The NHDS incidence data in Table 4 are directly comparable to those reported by Wilson et al. for 1994 and 1996 and by Hajjeh et al. for Baltimore, MD, in 1998 through 2000 (24 per 100,000).

    “The data in Table 4 are directly comparable to those reported by Wilson et al. (315) for the years 1994 and 1996 and by Hajjeh et al. (92) for the Baltimore, MD, metropolitan area (24 per 100,000) in 1998 through 2000.”

    From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [315]

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Authors
Wey, S. B.
Venue
Archives of Internal Medicine
Publisher
American Medical Association (AMA)
Published
1988-12-01
Volume
148
Issue
12
Pages
2642
ISSN
0003-9926 (ISSN-L)
DOI
10.1001/archinte.1988.00380120094019
OpenAlex
W1986506708
Cited by
831
References
30
Citations by year
2026: 3 · 2025: 5 · 2024: 3 · 2023: 10 · 2022: 6 · 2021: 3 · 2020: 13 · 2019: 11 · 2018: 10 · 2017: 7 · 2016: 11 · 2015: 13 · 2014: 25 · 2013: 24 · 2012: 22
FWCI
7.26
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
Keywords
candidemia, nosocomial infections, mortality, attributable mortality, length of hospital stay, economic burden, relative risk
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Candidiasis, Child, Child, Preschool, Cross Infection, Female, Humans, Infant, Infant, Newborn, Iowa, Length of Stay, Male, Middle Aged

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