Candidaemia in internal medicine departments: the burden of a rising problem

Abstract

Although internal medicine wards (IMWs) represent a significant reservoir of patients with candidemia, few investigators have specifically addressed the epidemiological aspects of candidaemia in this population. Of all patients hospitalized during the study period with candidaemia, 133/348 (38%) were admitted to IMWs. Variables associated with IMWs included: antibiotic therapy prior to hospitalization, urinary or central venous catheter, parenteral nutrition, tumour and age >75 years. Overall, 30-day mortality in IMWs was significantly higher than that in other wards (51.1% vs. 38.2%, p <0.02). Multiple logistic regression analysis identified the administration of antifungal treatment 48 h after having the first positive BC as an independent determinant of hospital mortality. Patients with candidaemia in IMWs account for a substantial proportion of patients with candidaemia and have higher mortality compared with patients in other wards.

Epidemiology, Species Distribution, Antifungal Susceptibility, and Outcome of Candidemia across Five Sites in Italy and Spain

“…Certainly, the severity of a patient's underlying medical condition greatly influences the crude mortality rate in these patient populations; however, for patients in internal medicine wards, inappropriate therapy (consisting mostly of omission of initial empirical therapy and an inadequate choice of antifungals) might represent an important variable that has been associated with increased mortality rates (41).…”

Epidemiology, species distribution, antifungal susceptibility and outcome of candidemia among Internal Medicine Wards of community hospitals of Udine province, Italy

“…5,14 Nevertheless, the majority of studies were performed in tertiary care hospitals where most of the Candida BSI are detected in intensive care units and solid organ transplant or hematological wards, with only few recent papers focusing also on internal medicine wards (IMW). 1,[15][16][17] The complete lack of data on candidemias in IMW Epidemiology, species distribution, antifungal susceptibility and outcome of candidemia among Internal Medicine Wards of community hospitals of Udine province, Italy N o n -c o m m e r c i a l u s e o n l y of community hospitals, prompted us to perform the present retrospective study on epidemiology, species distribution, antifungal susceptibility and outcome of Candida spp. BSI among primary care hospitals of Udine province.…”

Influencia de la colonización de vía aérea por Candida spp. en pacientes con Enfermedad Pulmonar Obstructiva Crónica en una unidad de cuidado intensivo de Colombia, durante el periodo 2010 a 2015.

“…Aunque no se estudiaron pacientes con demostración de infección asociada, estudios como el de Chen et al (7), han descrito la EPOC como factor de riesgo para el desarrollo de infecciones por Candida spp., adicionalmente, otras condiciones como la edad avanzada y las comorbilidades presentes en el grupo de pacientes con EPOC, han sido descritas como factores de riesgo para candidemia (17,18), resultados similares fueron publicados por Tang et al (19), en su estudio sobre los factores pronósticos de candidemia en pacientes ancianos, donde encontraron que los pacientes con índice de Charlson >7 presentaron mayor probabilidad de mortalidad respecto a pacientes con puntajes menores, estableciendo las comorbilidades como factor de riesgo para mortalidad en candidemia. Tabla 3.…”