Nosocomial Candidemia in Non-Neutropenic Patients at an Italian Tertiary Care Hospital
Abstract
In a retrospective study conducted in an Italian tertiary care hospital, the incidence of nosocomial candidemia was evaluated together with causative pathogens, treatment, and risk factors for death. Over a 6-year period (1992-1997), a total of 189 episodes of candidemia occurred in 189 patients (mean age 58+/-19 years), accounting for an average incidence of 1.14 episodes per 10,000 patient-days per year. The most common reasons for hospitalization were solid neoplasia (21%), trauma (17%), abdominal diseases requiring surgery (13%), and cardiovascular diseases (13%). No patient was neutropenic within 3 weeks prior to the onset of candidemia. One hundred thirty patients were hospitalized in intensive care units, 47 patients in surgical wards, and 12 patients in medical wards. Candida albicans was the most frequently isolated pathogen, accounting for 54% of fungal isolates, followed by Candida parapsilosis (23%), Candida glabrata (7%), Candida tropicalis (5%), Candida pelliculosa (4%), Candida lusitaniae (1%), Candida humicula (1%), and other non-albicans Candida spp. (5%). Seventy-six (41%) patients received adequate antifungal therapy. Seventy-one (58%) of the 123 evaluable patients with central venous catheters underwent line removal; 51 of them had catheter-related candidemia. The 30-day crude mortality rate was 45%. Older age, hospitalization in an intensive care unit, a longer duration of candidemia, retention of central lines, and inadequate antifungal therapy were significantly associated with poor outcome. In the present study, nosocomial candidemia was a frequent and relatively underestimated illness. Adequate antifungal therapy and central line removal independently reduced the high mortality of the disease.
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Catheter removal is associated with reduced mortality in adults and neonates with candidemia.
“includes data in which catheter removal was associated with reduced mortality in adults [108, 116] and neonates [117].”
From Guidelines for Treatment of Candidiasis (2004) · cites this paper as [116]
Most C. inconspicua isolates (70%) in the Majoros et al. report were from respiratory tract samples, but wound, blood, and genital isolates were also obtained.
“Most isolates (70%) were from respiratory tract samples, but wound, blood, and genital isolates were also obtained.”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [143]
C. inconspicua may be especially common in Hungary, where Majoros et al. reported on 57 isolates from 48 patients.
“C. inconspicua may be especially common in Hungary, where Majoros et al. (143) reported on 57 isolates from 48 patients.”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [143]
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- Authors
- Luzzati, R., Amalfitano, G., Lazzarini, L., Soldani, F., Bellino, S., Solbiati, M., Danzi, M. C., Vento, S., Todeschini, G., Vivenza, C., & Concia, E.
- Affiliations
- University of Verona (IT)
- Informa (Italy) (IT)
- Azienda Ospedaliera Universitaria Integrata Verona (IT)
- Venue
- European Journal of Clinical Microbiology & Infectious Diseases
- Published
- 2000-09-05
- Volume
- 19
- Issue
- 8
- Pages
- 602-607
- ISSN
- 0934-9723 (ISSN-L)
- 1435-4373
- OpenAlex
- W2044026522
- Cited by
- 179
- References
- 19
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 2 · 2018: 3 · 2017: 1 · 2016: 6 · 2015: 5 · 2014: 12 · 2013: 11 · 2012: 14
- FWCI
- 6.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Journal of Clinical Microbiology & Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Keywords
- nosocomial candidemia, non-neutropenic patients, Candida albicans, Candida parapsilosis, Candida glabrata, Candida tropicalis, central venous catheters, catheter-related candidemia, antifungal therapy, mortality risk factors, intensive care unit, incidence, non-albicans Candida
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Candida, Candidiasis, Child, Cross Infection, Female, Hospitals, University, Humans, Italy, Male, Middle Aged, Neutropenia, Retrospective Studies, Risk Factors, Causality, Incidence, Fungemia
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