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  • Meeting abstract
  • Open Access

Hospital urinary infection epidemic by Candida famata: reduction of mortality after therapy with fluconazole and identification of the risk factors related to the infection

  • 1,
  • 1,
  • 2,
  • 2,
  • 1 and
  • 1
Critical Care20004 (Suppl 1) :P88

https://doi.org/10.1186/cc808

  • Published:

Keywords

  • Fluconazole
  • Candidiasis
  • Anaerobic Bacterium
  • Etiological Agent
  • Secondary Infection

Full text

Background

The more recent studies have revealed that infections by Candida spp. have increased their participation as a hospital infection. Some clinical studies have revealed reduction of the mortality rates in critical patients treated for candiduria with fluconazole. In 1997 and 1998, we detected an epidemic outbreak of hospital urinary infection by C. famata, which determined an epidemiological investigation.

Objectives

Identify the risk factors for hospital candiduria by C. famata, the lethality attributed to this infection, as well as evaluate the impact of early treatment with fluconazole on the lethality of candiduria.

Results

This matched paired case-control study detected 19 cases of hospital infection by C. famata, fulfilling 100% of the pairing criteria with 38 patients of the control group. The univariate analysis revealed the following variables as risk factors for hospital candiduria by C. famata (P<0.05): Post-operative of abdominal surgery, previous use of antimicrobials with coverage for aerobic Gram-negative bacilli and anaerobic bacteria, the prolonged use of vesicular catheter (>4 days) and of antimicrobials. The greater time of use of antimicrobials was considered the only independent risk factor, obtained by multivariate analysis (OR=1.1). The lethality attributed to hospital candiduria by C. famata was 42% (P<0.05), with identification of secondary infection in the blood stream in two patients. All the patients who did not make use of fluconazole or other anti-fungal therapy for treatment of the candiduria (7 patients) evolved to obit. (P<0.05) No potential sources of infection were identified, with an endogenous source being attributed to as most probable for the occurrence of the outbreak.

Conclusion

The diagnosis of candiduria in critical patients remains as a characteristic related to the high morbidity and lethality. The institution of preventive measures such as the reduction of time of use of vesicular catheter, rational use of antimicrobials, and the early treatment of candiduria episodes in critical patients, are measures which can reduce the lethality related to this infection, considering candiduria as a predisposing factor to systemic candidiasis. The research of C. famata as etiological agent in hospital urinary infection must be taken into account in future studies.

Authors’ Affiliations

(1)
Hospital Evaldo Foz, Av. Vereador J. Diniz, São Paulo, CEP-04603-901, 3505, Brazil
(2)
Laboratório SAE, São Paulo, Brazil

Copyright

© Current Science Ltd 2000

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