Journal List > Korean J Clin Microbiol > v.11(1) > 1038148

Korean J Clin Microbiol. 2008 Apr;11(1):49-55. Korean.
Published online April 30, 2008.  https://doi.org/10.5145/KJCM.2008.11.1.49
Copyright © 2008 The Korean Society of Clinical Microbiology
Distribution and Clinical Characteristics of Fungal Species Isolated from Blood Cultures over a 7-year Period at a Tertiary-care Hospital
Hee-Young Yang, Hee-Joo Lee, and Jin-Tae Suh
Department of Laboratory Medicine, Kyung Hee University College of Medicine, Seoul, Korea.

Correspondence: Hee-Joo Lee, Department of Laboratory Medicine, Kyunghee University College of Medicine, 1, Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea. (Tel) 82-2-958-8674, (Fax) 82-2-958-8609, Email: leehejo@khmc.or.kr
Received October 25, 2007; Accepted March 04, 2008.

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.

Keywords: Fungemia; Predisposing factor; Mortality

Tables


Table 1
Clinical characteristics of 139 patients with fungemia
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Table 2
Fungus species isolated from blood cultures from 2000 to 2006
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Table 3
Distribution of the fungemia according to hospitalization unit
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Table 4
Therapeutic regimens for patients with fungemia
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Table 5
Univariate analyses of risk factors of fungemia-associated mortality in 129 patients
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