Tiraboschi Iris Nora, Pozzi Natalia Cintia, Farías Luciana, García Susana, Fernández Norma Beatriz
Universidad de Buenos Aires, Buenos Aires, Argentina.
Sección Bacteriología, Universidad de Buenos Aires, Buenos Aires, Argentina.
Rev Chilena Infectol. 2017 Oct;34(5):431-440. doi: 10.4067/S0716-10182017000500431.
The epidemiology of candidemia vary by region.
To determine the epidemiology of candidemia in a hospital for 16 years.
Episodes of candidemia occurred in the Hospital de Clinicas of Buenos Aires were reviewed, from 01/01/98 to 31/12/13.
374 episodes of candidemia were identified. The incidence was 2.21/1,000 discharges and increased from 1.96 (1998-2005) to 2.25 (2006-2013) (p = 0.023). Candidemia was diagnosed: 5.4% in neonates, 1.7% in infants, 6.5% in children, 31.8% in adults and 52.7% in elderly adults over 64 years old. The episodes were caused by C. albicans (40.9%), C. parapsilosis (21.7%), C. tropicalis (15.5%), C. glabrata (13.9%), other species of Candida (5.1%) and more than one species of Candida (2.9%). The 5.3% of the isolates were resistant to fluconazole. 74% of patients were treated. Initial treatments were with fluconazole (70.3%), amphotericin B deoxycholate (25%), echinocandins or lipidic amphotericin (4,7%). The 81% of central venous catheters were taken off. Mortality rate was of 47.9%, but in the elderly adults was of 60.8%.
The incidence of candidemia showed an increase over the years. It was higher in the elderly adults, being the group with worse outcomes.
念珠菌血症的流行病学因地区而异。
确定一家医院16年来念珠菌血症的流行病学情况。
回顾了1998年1月1日至2013年12月31日在布宜诺斯艾利斯临床医院发生的念珠菌血症病例。
共鉴定出374例念珠菌血症病例。发病率为2.21/1000例出院患者，且从1998 - 2005年的1.96上升至2006 - 2013年的2.25（p = 0.023）。念珠菌血症的诊断情况如下：新生儿中占5.4%，婴儿中占1.7%，儿童中占6.5%，成年人中占31.8%，64岁以上老年人中占52.7%。这些病例由白色念珠菌（40.9%）、近平滑念珠菌（21.7%）、热带念珠菌（15.5%）、光滑念珠菌（13.9%）、其他念珠菌属（5.1%）以及多种念珠菌（2.9%）引起。5.3%的分离株对氟康唑耐药。74%的患者接受了治疗。初始治疗使用氟康唑（70.3%）、去氧胆酸两性霉素B（25%）、棘白菌素或脂质体两性霉素（4.7%）。81%的中心静脉导管被拔除。死亡率为47.9%，但老年人中的死亡率为60.8%。
念珠菌血症的发病率多年来呈上升趋势。在老年人中发病率更高，且该群体预后较差。
