There were 71 patients with
candidemia in our hospital from November 1, 1993 to October 31, 1999. We investigated the 59 patients from isolated species, route of
infection, underlying disorders, risk factors, complications, treatment and prognosis.Candida albicans was the most commonly isolated species (52%), followed by Candida tropicalis (11%). Eighty eight percent of the patients developed
candidemia from
central venous catheter related
infections. The risk factors to
candidemia included keeping the
catheter in place for more than 5 days, gastrointestinal tract
malignancies, postoperative state of gastrointestinal tract surgery, administration of broad-spectrum or combination
antibiotics for more than 5 days, and under
corticosteroid therapy. About half of the patients (47%) had complications, including
endophthalmitis (19 patients, 32%),
septic shock (12 patients, 20 %). Mortality rate associated with
candidemia was 46%. Mortality rate was lower in 20 patients who were treated with
amphotericin B (40%) than in 34 patients treated with only
fluconazole (50%), but it was not statistically significant. In order to make an early diagnosis of
candidemia, taking blood cultures and ophthalmologic examinations are essential, especially for patients who have those risk factors to
candidemia mentioned above. If the patient was suspected of having
catheter related infection, the
catheter should be removed quickly and the
catheter tip should be cultured. Once
candidemia is found, ophthalmologic examination and systemic antifungal
therapy are needed. Antifungal
therapy with
Amphotericin B should be used for patients with severe
candidemia or with candide-