ungemia plays an important role in hospital infections, and the incidence is increasing.
We designed this study for the clinical evaluation of nosocomail fungemia, such as, annual
occurrence, predisposing factors, underlying diseases, and prognosis.
We analyzed the records of 33 cases of nosocomial fungemia occurred in Kyung-Hee
university hospital between 1985 and 1991.
The results were as follows ;
1) Among a total of 33 cases of nosocomial fungemia, the number of yearly occurrence
from 1985 to 1991 were 1,2,1,2,7,9 and 11 respectively. Most of them occurred in recent 3
years (27 cases, 82%).
2) Among them, 12 cases were male and 21 cases in female. The ratio of male and
female was 1:1.75, indicating that the rate of occurrence was high in female.
3) The age distribution ranged from 18 to 80 with a mean age of 56.1 years. The high
occurrence of age was between the 50's and 60's (57.5%).
4) Infecting fungal organisms were C. albicans, C. tropicalis, C. parapsilosis, T. galabrata,
T. maris, T. Inconspicus, and Saccharomyces rosel. The most common organism was C.
Albicans (60.6%).
5) 17 cases had evidence of fungal infections at other sites; urine (39.2%), central venou
catheter (21.7%), wound (21.7%), and sputum (17.4%).
6) The predisposing risk factors wre prior antibiotic therapy (93.9%), ccentral venous
catheter insertion (72.7%), and immunosuppressive therapy (57.6%).
7) 17 cases had concomitant bacterial infections, and the most common site of bacterial
infections was urinary tract infection (48%). Staphylococcus aureus (28%), pseudomonas
aeruginosa (24%), serratia marscens (16%), and streptococcus fecalis (16%) were isolated.
8) Cerebrovascular diseases (33.3%) were the major underlying diseases (15.2%), and
hematologic malignancies (12.1%) were the following underlying diseases in order.
9) The mortality was 37.5% in treated caes and 64.7% in untreated cases. Overall
mortality was 51.5%.
10) Mortality according to fungal species were 63% in C. albicans and 33.3% in C.
Tropicalis.
In conclusion, nosocomial fungemia is an important hospital infection which may occur
during hospitalization, especially in conditions with predisposing factors, such as prior
antibiotic therapy, central venous catheter insertion, and immunosuppressive therapy.
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