Epidemiology and prognosis of candidaemia in elderly patients

Antonio Ramos-Martínez, Natalia Vicente-López, Isabel Sánchez-Romero, Belén Padilla, Paloma Merino-Amador, José Garnacho-Montero, Isabel Ruiz-Camps, Miguel Montejo, Miguel Salavert, José Mensa, Manuel Cuenca-Estrella, Members of the CANDIPOP Project from GEIH-GEMICOMED (SEIMC) and REIPI

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Abstract

The aim of the study was to analyse the epidemiology and prognosis of candidaemia in elderly patients. We performed a comparison of clinical presentation of candidaemia according to age and a study of hazard factors within a prospective programme performed in 29 hospitals. One hundred and seventy-six episodes occurred in elderly patients (>75 years), 227 episodes in middle-aged patients (61-75 years) and 232 episodes in younger patients (16-60 years). Central venous catheter, parenteral nutrition, neutropenia, immunosuppressive therapy and candidaemia caused by Candida parapsilosis were less frequent in elderly patients. These patients received inadequate antifungal therapy (57.3%) more frequently than middle-aged and younger patients (40.5% P < .001). Mortality during the first week (20%) and 30 days (42%) was higher in elderly patients. The variables independently associated with mortality in elderly patients during the first 7 days were acute renal failure (OR: 2.64), Pitt score (OR: 1.57) and appropriate antifungal therapy (OR: 0.132). Primary candidaemia (OR: 2.93), acute renal failure (OR: 3.68), Pitt score (OR: 1.38), appropriate antifungal therapy (OR: 0.3) and early removal of the central catheter (OR: 0.47) were independently associated with 30-day mortality.In conclussion, inadequate antifungal treatment is frequently prescribed to elderly patients with candidaemia and is related with early and late mortality.

Original languageEnglish
Pages (from-to)808-817
Number of pages10
JournalMycoses
Volume60
Issue number12
DOIs
Publication statusPublished - Dec 2017
Externally publishedYes

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  • Journal Article

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    Ramos-Martínez, A., Vicente-López, N., Sánchez-Romero, I., Padilla, B., Merino-Amador, P., Garnacho-Montero, J., Ruiz-Camps, I., Montejo, M., Salavert, M., Mensa, J., Cuenca-Estrella, M., & Members of the CANDIPOP Project from GEIH-GEMICOMED (SEIMC) and REIPI (2017). Epidemiology and prognosis of candidaemia in elderly patients. Mycoses, 60(12), 808-817. https://doi.org/10.1111/myc.12677