Korean J Infect Dis.  2000 Oct;32(5):373-379.

Clinical Evalution of the Incidence and Outcome of Patient with Fungemia

• Choi YH
• Park YS
• Jo JH
• Hong SK
• Chang KH
• Song YG
• Kim JM

Abstract

BACKGROUND: Fungus is the common pathogen of nosocomial infection, and the 4th common pathogen of nosocomial bloodstream infection. We evaluated the annual occurrence, the relation between fungemia and central venous catheter-related infection, the risk factors and survival rate of fungemia.
METHODS
We reviewed medical record of 209 cases with fungemia occurred in the period of from 1992 to 1997 in Severance hospital retrospectively.
RESULTS
The annual occurrence of nosocomial fungemia was 3.9, 6.7, 6.7, 7.8, 13.6, 8.0, per 10,000 patient discharges in 1992, 1993, 1994, 1995, 1996, 1997. The species of fungemia wete Candida albicans (47.79o), C. glabrata (12.1%), C. parapsilosis (11.7%), C. tropicalis (11.2/o), C. guilliermondii (1.9fo), C. krusei (1.9%), Rhodotorula species (2.3%), Trichosporon species (1.9%), molds (4.7%). The proportion of definite catheter-related bloodstream infection was 41.6%, probable catheter-related bloodstream infection 28.2%, and the fungemia that was not related with central venous catheter infection was 30.1%. Mortality rate of fungemia was 53.6%, and median survival days were 29 days. Catheter removal and antifungal therapy increased survival rate, but persistent fungemia and thrombocytopenia were poor prognostic factors.
CONCLUSION
The fungal bloodstream infection is increased and high proportion of fungemia is related to central venous catheter-related infection. Since catheter removal and antifungal therapy have benefit on survival rate, early evaluation of catheter-related infection and antifungal therapy in fungemia patient is recommended.

Keyword

Fungemia; Central venous catheter; Catheter-related bloodstream infection

MeSH Terms

Candida albicans
Catheter-Related Infections
Catheters
Central Venous Catheters
Cross Infection
Fungemia*
Fungi
Humans
Incidence*
Medical Records
Mortality
Patient Discharge
Retrospective Studies
Rhodotorula
Risk Factors
Survival Rate
Thrombocytopenia
Trichosporon