1442. Severity of the Candidemia and Surveillance of Candida species in Critically Ill Patients
Session: Poster Abstract Session: Fungal Infections
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background: The severity of candidemia is unexpected event, while in some patients it is transient and absent of manifestations, others develop severe manifestations of infection. The surveillance of the Candidaspecies in hematogenous candidiasis and their associated mortality is an important component of strategies for controlling and treatment. The present study determined the severity and behavior of candidemia in critically ill patients. 

Methods: From January 2000 to December 2010, we prospectively review all Candida isolated from a 14-bed medical and surgical adult Intensive Care Unit (ICU). Identification of Candida and susceptibility to antifungal agents was determined by Sensititresystem.

Results: During a 10-year period, of 6509 admissions to the ICU, 80 patients were identified with candidemia. The rate of candidemia was 12 per 1,000 admissions. The frequency of candidemia was variable from year to year. There were 65 patients with candidemia by Candida alone, 8 with Candida and bacteremia and 7 with different Candida species. Of 65 patients, only 31 were included in the analysis. Fifty three species of Candida isolates from blood cultures were obtained from 31 patients. Candidemia was ICU-acquired in 21 (68 %), hospital ward-acquired in 7 (22%) and community- acquired in 3 (10%). One episode of candidemia was present in 23 (74%) patients and 8 (26%) had more than one episode. C. tropicalis and C. albicans  were the most common isolated in 65% of the patients. Only 8% of the C. tropicalis isolates were resistant to fluconazole. The mortality for patients with candidemia was of 55%. Ten (32%) of the patients died during the first 7 days of stay in ICU. C. tropicalis was associated with increase mortality.  The mean length of ICU stay was 16 days.

Conclusion: C. tropicalis and C. albicans were the species most frequently isolates. C. tropicalis was associated with increased mortality. Susceptibility testing is helpful in the early prompt and appropriate antifungal therapy for infected critically ill patients.

Guadalupe Aguirre-Avalos, PhD, MD1,2, Mónica A. Camarena-Naranjo, MD2, Nancy G. Canela-Bautista, MD1, Adriana E. Rosas-Pérez, MD2, Pavel E. Aguilera-González, MD1, Fabio Carabez-Andrade, MD1, Julio C. Mijangos-Méndez, MD2, Antonio G. Rojas-Sánchez, MD2, Federico Corona-Jiménez, MD2, Hilario Coronado-Magaña, MD2 and Gerardo Amaya-Tapia, PhD1, (1)Universidad de Guadalajara, Guadalajara, Jalisco, Mexico, (2)Hospital Civil de Guadalajara, Guadalajara, Jalisco, Mexico

Disclosures:

G. Aguirre-Avalos, None

M. A. Camarena-Naranjo, None

N. G. Canela-Bautista, None

A. E. Rosas-Pérez, None

P. E. Aguilera-González, None

F. Carabez-Andrade, None

J. C. Mijangos-Méndez, None

A. G. Rojas-Sánchez, None

F. Corona-Jiménez, None

H. Coronado-Magaña, None

G. Amaya-Tapia, None

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