Distribution and Clinical Characteristics of FungalSpecies Isolated from Blood Cultures over a 7-yearPeriod at a Tertiary-care Hospital / 대한임상미생물학회지

ABSTRACT

BACKGROUND: Fungemia has increased over the past decade and is an important cause of significant morbidity and mortality. Since 1980, there has been an increase in the worldwide studies of nosocomial bloodstream fungal infections. We analyzed the distribution and the clinical characteristics of fungemia at a tertiary care hospital, Kyung Hee University hospital. METHODS: We retrospectively reviewed medical records and laboratory findings of 139 patients who had fungemia from January 2000 to December 2006. We investigated the incidence of each fungal species, yearly occurrence, underlying diseases, hospitalized units, predisposing factors, use of the antifungal agents, mortality, and the characteristics of the expired group. RESULTS: The most common species isolated was C. albicans (40.3%), followed by C. tropicalis (24.5%). Overall, fungemia occurrence showed an increasing trend during the study period, except for the year 2004. Common predisposing factors were previous antimicrobial therapy (89.2%), central venous catheter (78.4%), and ICU admission state at diagnosis (59.7%). among the 139 patients, 98 (70.5%) were treated. Primary choice of antifungal agents included fluconazole (70.4%) and amphotericin B (29.0%). Overall mortality was 38.9% with the highest rate (47.1%) in patients with C. tropicalis and the lowest one (22.2%) in patients with C. parapsilosis. Predisposing factors for mortality due to fungemia in the univariate analysis included only mechanical ventilation (P=0.008). CONCLUSION: Fungemia in the tertiary care hospital was caused predominantly by C. albicans and followed by C. tropicalis. The mortality rate was high and interspecies differences existed.