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December 1987

Nosocomial Fungemia in a Large Community Teaching Hospital

Author Affiliations

From the Northeastern Ohio Universities College of Medicine, Rootstown (Drs Harvey and Myers), the Department of Medicine, Western Reserve Care System, Youngstown, Ohio (Dr Harvey), and the Department of Internal Medicine, Division of Infectious Diseases, Akron (Ohio) General Medical Center (Dr Myers). Dr Harvey is now with the Division of Infectious Diseases, Wayne State University—Detroit Medical Center.

Arch Intern Med. 1987;147(12):2117-2120. doi:10.1001/archinte.1987.00370120053011

• This report reviews 48 episodes of hospital-acquired fungemia that occurred over a four-year period at a large community teaching hospital. The incidence of hospital-acquired fungemia increased eightfold during the study period. Candida albicans (58%), Candida tropicalis (25%), and Candida parapsilosis (15%) were the most common fungal pathogens isolated from blood cultures. Twenty-one patients (44%) had concomitant bacteremia. Intravascular catheters (100%), antibiotic administration (98%), urinary catheters (81%), surgical procedures (65%), parenteral alimentation (60%), and corticosteroid administration (54%) were the most common predisposing factors. The overall mortality rate was 75%. Hospitalization on the medical service, age greater than 60 years, and hospital stay less than 100 days were associated with a significantly increased mortality rate.

(Arch Intern Med 1987;147:2117-2120)