Incidence, etiology and risk factors associated with mortality of nosocomial candidemia in a tertiary care hospital in Istanbul, Turkey.

OBJECTIVE The aim of this study was to determine the incidence, etiology and risk factors for mortality of patients with nosocomial candidemia. SUBJECTS AND METHODS This observational study was performed at Haydarpasa Numune Training and Research Hospital, a tertiary care hospital with 750 beds, between the years 2004 and 2007. Fifty defined cases with a nosocomial bloodstream infection caused by Candida species were included in the study. All demographic, microbiological and clinical records for each patient were collected using a standardized form. Blood culture was performed by automated blood culture system, and those samples positive for yeast were subcultured on Sabouraud agar. RESULTS The mean incidence density of nosocomial candidemia was 0.58/10,000 patient-days/year (range 0.17-1.4). Candidemia episodes increased from 0.17/10,000 to 1.4/10,000 patient-days/year (p < 0.0001). Candida albicans and non-albicans Candida accounted for 15 (30%) and 35 (70%) cases, respectively. The overall mortality was 56% and was significantly associated with stayingin the intensive care unit (odds ratio: 3.667, 95% confidence interval: 1.07-12.54, p = 0.034). CONCLUSION This study showed that there was a significantly increased trend in the incidence of candidemia with high mortality during the study period.