Abstract

CABALLERO, Ernesto; BOZA, Ricardo  and  GONZALEZ, Kenneth. Candidiasis sistémica: experiencia en el Hospital San Juan de Dios 1996-1998. Rev. costarric. cienc. méd [online]. 1999, vol.20, n.3-4, pp.153-165. ISSN 0253-2948.

The mortality of patients with chronic diseases and those with agressive medical and surgical therapies has decreased in recent years, specially due to the use of broad spectrum antibiotics, parenteral nutrition, immunosupressives therapies, organ transpiantation and management of those patients in intensive care units.  However, new infectious diseases have emerged in this population, for example candidal infections.  We do not have reports in Costa Rica about this problem.  The objective of this study was to analized, retrospectiviy, demographic characteristics, risk factors, microbiologic findings, mortaiity and treatment of patients with candidal bloodstream infections between January 1996 and December 1998, in the Hospital San Juan de Dios, a costarrican reference hospital.  Forty seven patients with 48 systemic candidiasis episodes met the criteria to be included in our study.  Sixty percent were men and the mean age was 53 years oid.  The mortality rate was 36%.  All the patients presentes at least, one risk factor.The most common were the use of broad spectrum antibiotics (87%), the presence of central venous catheter(72%), candidiasis in other anatomic site (64%), previous abdominal surgery (25%),use of parenteral nutrition (23%) and neutropenia (17%).  The species isolated were: C albicans (47%), C tropicalis (19%), C parapsilosis (11%), C krusei (4%) and C glabrata (2%).  The last two species were related to the previous use of antimycotic azoles.  The use of an early specific antimycotic treatment was related with low mortaiity rate.  We discussed our data and we found similar results in previous reports in the medical literature.

Keywords : candidemia; septicemia; fungal infections; antimycotic treatment.