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| Epidemiology and risk factors for short-term outcomes of yeast bloodstream infection—A five-year retrospective analysis |
| LIU Xiao-Ying1, WU Lin2, CHEN Ying1, YANG Zhi-Tao1,3, ZHOU Min4, LI Jie4, MAO En-Qiang1, CHEN Er-Zhen1 |
| 1. Department of Emergency & Emergency Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 2. Department of Geriatric, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 3. Pôle Sino-Français de Recherches en Science du Vivant et Génomique, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 4. Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China. |
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Abstract Yeasts, especially Candida, are important pathogens causing bloodstream infections (BSIs), responsible for significant mortality and morbidity among hospitalized patients. The present paper aims to report the current epidemiology of yeast BSI in Ruijin Hospital from January 2008 to December 2012, and to estimate the impact of appropriate antifungal therapy on the outcomes. The incidence of nosocomial yeast BSI was 0.34 episodes /1 000 hospitalized patients, and the overall crude 28-day mortality rate was 27.1%. The proportion of yeast BSI caused by non- Candida albicans (C. albicans)(65.1%) including C. parapsilosis (18.6%), C. tropicalis (14.0%), C. glabrata (7.0%), C. guilliermondii (5.4%) and C. sake (4.7%) was higher than that of C. albicans (34.9%). Among 129 cases of yeast BSI, 78.3% (101 cases) received empiric antifungal therapy of which only 69.8% (90 cases) were considered appropriate, while 21.7% (28 cases) did not receive any antifungal agent. The mortality was significantly lower in those who received appropriate empiric antifungal therapy compared with those who received inappropriate empiric antifungal therapy (20.0% vs. 43.6%, P=0.006) within 5 d of the onset. The age (HR=1.036, P=0.005) and neutropenia <500/mm3 (HR=15.497, P<0.001) were independent risk factors for 28-day mortality, while appropriate empiric antifungal therapy (HR=0.325, P=0.002) was protective factor. Appropriate empiric antifungal therapy influenced the short-term survival.
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Received: 01 August 2013
Published: 01 January 2013
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Corresponding Authors:
YANG Zhi-Tao
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