Poster Session : PS 0436 ; Infectious Disease ; Candidemia: A Poor Prognosis. Experience of 104 Cases = Poster Session : PS 0436 ; Infectious Disease ; Candidemia: A Poor Prognosis. Experience of 104 Cases

다국어 초록 (Multilingual Abstract)

Background: To analyze the clinical features, epidemiology, diagnosis and treatment of candidemia treated in a tertiary care hospital. Methods: From 2007 to 2013, patients with candidemia were identifi ed at a hospital in Spain.The medical records of all patients with bloodstream infections due to Candida species were retrospectively reviewed. Results: During the six-year period, a total of 104 episodes of candidemia were identifi ed, 70 men (67%) and 46 women (33%), with a mean age of 65 years (range 16- 83). risk factors for candidemia were: neoplasms (41%), diabetes (25%) and renal failure (16%). Candidemia was associated with the presence of invasive devices such as central venous catheter (52%), urinary catheter (48%) and the presence of previous antibiotic treatment (80%) and abdominal surgery (42%). The most frequent form of clinical presentation was sepsis in 67 patients (65.7%) and seven patients were diagnosed with endocarditis. C. albicans (46%) was the most common pathogen, followed by C. parapsilosis (24%) and C. glabrata (17%). (8%). Ninety-three patients (89%) received empirical antifungal therapy and in 72 (78%) was appropriate. Antifungal administered in order of frequency were: fi uconazole 68 patients (65%), caspofungin at 9 (9.5%), amphotericin B, 8 (7%) and voriconazole (2%). Mortality in the fi rst 30 days following the candidemia was 46% (n = 48). Risk factors that were associated with mortality were age> 60 years (p = 0.002), insuffi cient renal (p = 0.03), candidemia unknown focus, or abdominal focus (p = 0.008) and empirical treatment Inappropriate (p = 0.001). Conclusions: The mortality of candidemia in our country is high, and inappropriate treatment is the only factor improved prognosis. A high index of suspicion is essential for diagnosis. The existence of protocols and practice guidelines are necessary to improve the management of infection and prognosis.