San Miguel Lucia Garcia, Cobo Javier, Otheo Enrique, Sánchez-Sousa Aurora, Abraira Victor, Moreno Santiago
Infectious Diseases Department, Ramón y Cajal Hospital, Madrid, Spain.
Infect Control Hosp Epidemiol. 2005 Jun;26(6):548-52. doi: 10.1086/502582.
To analyze the secular trends of candidemia in a large tertiary-care hospital to determine the overall incidence, as well as the incidence by ward and by species, and to detect the occurrence of outbreaks.
Retrospective descriptive analysis. Secular trends were calculated using the Mantel-Haenszel test.
A large tertiary-care referral center in Spain with a pediatric intensive care unit (ICU) to which more than 500 children with congenital cardiac disease are admitted annually.
All patients with candidemia occurring from 1988 to 2000 were included. Cases were identified from laboratory records of blood cultures.
There were 331 episodes of candidemia. The overall incidence of nosocomial candidemia was 0.6 episode per 1,000 admissions and remained stable throughout the study period (P = .925). The species most frequently isolated was Candida albicans, but the incidence of C. parapsilosis candidemia increased (P = .035). In the pediatric ICU, the incidence of C. parapsilosis was 5.6 episodes per 1,000 admissions and it was the predominant species. Outbreaks occurred occasionally in the pediatric ICU, suggesting nosocomial transmission.
During this 13-year period, the incidence of candidemia remained stable in this hospital, but C. parapsilosis increased in frequency. Occasional outbreaks of candidemia suggested nosocomial transmission of Candida species.
分析一家大型三级医疗医院念珠菌血症的长期趋势，以确定总体发病率、各病房及各菌种的发病率，并检测暴发情况。
回顾性描述性分析。使用Mantel-Haenszel检验计算长期趋势。
西班牙一家大型三级医疗转诊中心，设有儿科重症监护病房（ICU），每年收治500多名先天性心脏病患儿。
纳入1988年至2000年期间所有发生念珠菌血症的患者。病例从血培养实验室记录中识别。
共发生331例念珠菌血症。医院内念珠菌血症的总体发病率为每1000例入院患者0.6例，在整个研究期间保持稳定（P = 0.925）。最常分离出的菌种是白色念珠菌，但近平滑念珠菌血症的发病率有所增加（P = 0.035）。在儿科ICU，近平滑念珠菌的发病率为每1000例入院患者5.6例，且是主要菌种。儿科ICU偶尔发生暴发，提示存在医院内传播。
在这13年期间，该医院念珠菌血症发病率保持稳定，但近平滑念珠菌的发生率增加。念珠菌血症的偶尔暴发提示念珠菌属存在医院内传播。
