Objectives:
@EN In recent years, fungi have played an increasingly important role as pathogens in nosocomial infection, and the incidence of nosocomial fungemia appears to be increased as a result of clinical and therapeutic factors. We investigated the
incidence
of fungemia and relation between the predisposing factors and fungal species to be helpful in the prevention and early diagnosis of nosocomial fungemia.
@ES Methods:
@EN We reviewed 45 cases of fungemia in Ewha Womans University dongdaemoon Hospital from jan. 1991 to Oct. 1995 to examine the predisposing factors, underlying illness, concomitant bacteremia, mortality and outcome by the fungal species.
@ES Results:
@EN During recent five years, fungemia was increased in incidence. Candida albicans (C. albicans) was the most common species of fungemia(36%), followed by C. parapsilosis(25%), C. tropicalis (18%), C. glabrata(11%), C. guilliermondii(4%) and the
uncommon species were Cryptococcus neoformans (2%), Saccharomyces cerevisiae(2%) and Fusarium species(2%). Solid tumors(23%) was the most common underlying disease in the patients with fungemia, followed by trauma (18%), hematologic mlignancy
(13%),
cerebrovascular attack(10%), prematurity (10%) and other nononcologic disease was 2.6%. C. albicans was commonly associated with nononcologic disease, especially prematurity (100%) and was frequently preceded by parenteral antibiotics (92%),
intravenous
catheterization (39%) and parenteral hyperalimentation(39%). C.parapsilosis was commonly associated with trauma (57%), cerebrovascular attack(50%) and was preceded by intravenous cathetrization (82%), steroid(73%), parenteral
hyperalimentation(45%)
and
concomitant bacteremia(45%). C. tropicalis occurred most frequently in hematologic malignancy(60%) and was frequently preceded by neutropenia and chemotherapy. C. glabrata and C. guilliermondii were most commonly associated with solid tumors and
was
preceded by abdominal surgery and parenteral hyperalimenation in all cases. Other rate fungi were Cryptococcus neoformans, Saccharomyces cerevisiae and Fusarium species which were associated with diabetes mellitus, systemic lupus erythematosus
and
aplastic anemia, respectively. Overall mortality of fungemia was 21% and C. parapsilosis(18%) and C. tropicalis (14%)were more favorable outcome than C. glabrata(25%) and C. albicans(23%).
@ES Conclusion:
@EN These results suggest that the incidence of fungemia are increased as a result of various predispoisng factors and removal of the predisposing factors will be helpful in the prevention of nosocomial fungemia.
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