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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
1
|
| pubmed:dateCreated |
1996-7-12
|
| pubmed:abstractText |
The incidence of nosocomial candidemia increased 27-fold over the past 13 years at National Taiwan University Hospital. In order to investigate its predisposing factors, clinical manifestations and prognostic determinants, a prospective observational study of nosocomial candidemia was undertaken at the hospital. From 1 May 1994 to 30 April 1995, 118 consecutive adult patients with 120 Candida spp blood isolates were analyzed. Clinical presentations included fever (100%) with a median duration of 3 days, diarrhea within 7 days of candidemia (27.9%) and macronodular skin emboli (7.6%). Laboratory studies showed worsening azotemia (35.6%), elevation of aminotransferase (28.3%), leukocytosis (27.1%) and thrombocytopenia (23.3%). Use of multiple antibiotics, retained vascular catheters and parenteral nutritional support were the three most common predisposing factors for candidemia. C. albicans was the most common isolate (50%), followed by C. tropicalis (20%), C. glabrata (14%), C. parapsilosis (9.2%). C. guilliermondii (2.5%), and C. Krusei (1.7%). C. tropicalis was more frequently the cause of candidemia in patients with leukemia and neutropenia, while C. glabrata was more commonly seen in patients receiving fluconazole prophylaxis. A severity scoring system adopted from prospective bacteremia studies proved to be highly predictive of mortality in candidemic patients. The overall case fatality rate was 70/118 (59.3%), and 51/70 (72.9%) were attributable to candidemia. In a multivariate analysis, the prognostic factors adversely influencing outcome were: higher severity scores, no removal of the catheter, persistent candidemia and lack of antifungal therapy.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Jan
|
| pubmed:issn |
0929-6646
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
95
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
19-28
|
| pubmed:dateRevised |
2006-11-15
|
| pubmed:meshHeading |
pubmed-meshheading:8640090-Adult,
pubmed-meshheading:8640090-Aged,
pubmed-meshheading:8640090-Aged, 80 and over,
pubmed-meshheading:8640090-Candidiasis,
pubmed-meshheading:8640090-Cross Infection,
pubmed-meshheading:8640090-Female,
pubmed-meshheading:8640090-Fungemia,
pubmed-meshheading:8640090-Hospitals, University,
pubmed-meshheading:8640090-Humans,
pubmed-meshheading:8640090-Male,
pubmed-meshheading:8640090-Middle Aged,
pubmed-meshheading:8640090-Multivariate Analysis,
pubmed-meshheading:8640090-Prognosis,
pubmed-meshheading:8640090-Prospective Studies,
pubmed-meshheading:8640090-Taiwan
|
| pubmed:year |
1996
|
| pubmed:articleTitle |
Nosocomial candidemia in a university hospital in Taiwan.
|
| pubmed:affiliation |
Department of Internal Medicine, National Taiwan University Hospital, Taipei, ROC.
|
| pubmed:publicationType |
Journal Article,
Research Support, Non-U.S. Gov't
|