Zantac Research Today is a free monthly online journal that collates and summarizes the latest research about Zantac, including details on ranitidine, side-effects, allergic reactions, information. | ||||||||
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Risk factors and outcome for nosocomial breakthrough candidaemia.Pasqualotto AC, Nedel WL, Machado TS, Severo LC Department of Infection Control, Santa Casa Complexo Hospitalar, Porto Alegre, Brazil. alessandro.pasqualotto@manchester.ac.uk OBJECTIVES: To describe all cases of nosocomial candidaemia that occurred in patients in use of anti-fungals. METHODS: Retrospective cohort study (1995-2003). Breakthrough candidaemia was defined as the occurrence of candidaemia in a patient receiving at least 3 days of systemic anti-fungal therapy. Patients with breakthrough candidaemia were compared to patients with non-breakthrough candidaemia. RESULTS: During the period of study, 20 patients had breakthrough candidaemia, and 40% of them had cancer. While most of these episodes occurred with amphotericin B, some patients received low-dose regimens of fluconazole or ketoconazole in association with ranitidine. Non-Candida albicans species caused 75% of these infections, mainly Candida parapsilosis (30%). When compared to controls (n=171), the breakthrough group had more frequently mucositis, longer stay in the intensive care unit, and longer periods of hyperalimentation, mechanical ventilation, urinary catheter and broad-spectrum antibiotics. Candida isolation from sites other than blood occurred more frequently in the breakthrough group. Mortality rate and Candida species distribution were similar among groups. CONCLUSIONS: C. parapsilosis was the main aetiology of breakthrough candidaemia. Common risk factors included mucositis, isolation of Candida from sites other than blood, use of broad-spectrum antibiotics, and invasive medical procedures. No difference in the mortality rate was observed. Published 28 February 2006 in J Infect, 52(3): 216-22.
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