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Volume 12, Number 10—October 2006

Research

Active Surveillance of Candidemia, Australia

Sharon Chen*Comments to Author , Monica Slavin†, Quoc Nguyen‡, Deborah Marriott‡, E. Geoffrey Playford§, David Ellis¶, Tania Sorrell*#, and the Australian Candidemia Study
Author affiliations: *Westmead Hospital, Westmead, New South Wales, Australia; †Royal Melbourne Hospital, Melbourne, Victoria, Australia; ‡St. Vincent's Hospital, Sydney, New South Wales, Australia; §Princess Alexandra Hospital, Brisbane, Queensland, Australia; ¶Women's and Children's Hospital, Adelaide, South Australia, Australia; #University of Sydney, Sydney, New South Wales, Australia

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Table 2

Selected concomitant conditions, risk factors, and outcomes for 919 episodes of candidemia by healthcare setting, Australia, 2001–2004*

Characteristic Healthcare-associated, outpatient acquired (n = 107) Healthcare-associated, inpatient acquired (n = 749) p value† Community acquired (n = 63) p value†
Concomitant condition
Hematologic malignancy 27 (25.2) 131 (17.5) 0.06 1 (1.6) <0.001
Solid organ malignancy 21 (19.6) 135 (18.1) 0.69 8 (12.7) 0.30
Solid organ transplantation 2 (1.9) 22 (2.9) 0.76
HSCT 3 (2.8) 25 (3.4) 1.0
Prematurity 35 (4.7) 1 (1.6) 0.37
Renal disease‡ 10 (9.3) 56 (7.5) 0.44 2 (3.2) 0.24
GI and liver disease§ 17 (15.9) 162 (21.6) 0.20 12 (19.0) 0.67
Pancreatitis 1 (0.9) 24 (3.2) 0.35
Cardiovascular disease¶ 17 (15.9) 118 (15.8) 1.0 4 (6.3) 0.09
Diabetes mellitus 14 (13.1) 111 (14.8) 0.77 12 (19.0) 0.37
Risk factor
Surgery in past 30 d 16 (15.7) 353 (49.0) <0.001 4 (6.9) 0.08
Burns/trauma 40 (5.5) 1 (1.8)
VAD 72 (69.2) 653 (90.8) <0.001 5 (9.1) <0.001
Hyperalimentation 13 (12.6) 318 (44.1) <0.001 1 (1.8) 0.04
Neutropenia 19 (18.1) 144 (19.6) 0.79 1 (1.6) 0.002
Antimicrobial agents 69 (65.7) 686 (95.5) <0.001 19 (34.5) <0.001
Corticosteroids 29 (28.4) 236 (33.0) 0.43 1 (1.6) <0.001
Chemotherapy 27 (25.2) 106 (14.2) 0.01
Systemic antifungal use 15 (14.0) 106 (14.2) 1.0
Intravenous drug use 2 (1.9) 13 (1.7) 1.0 15 (23.3) <0.001
Other BSI 15 (14) 256 (34.2) <0.001 5 (8) 0.33
Sepsis syndrome 74 (69.2) 594 (79.3) 0.01 37 (58.7) 0.71
Candida endocarditis 7 (6.5) 22 (2.9) 0.08 5 (7.9) 0.55
Mean time in hospital, d 18.1 56.7 <0.001 16.1 0.33
Death within 30 d 13 (12.4) 218 (31.1) <0.001 6 (9.4) 1.0

*Data are no. (%) of total cases in each category, except for mean time in hospital. Some patients had >1 concomitant condition or risk factor. HSCT, hemopoietic stem cell transplant; GI, gastrointestinal; VAD, vascular access device; BSI, bloodstream infection.
†By χ2 test using outpatient healthcare-associated data as baseline.
‡Hemodialysis or peritoneal dialysis.
§Biopsy-proven cirrhosis with portal hypertension, past upper GI bleeding caused by portal hypertension, or prior episodes of hepatic failure.
¶Severe congestive heart failure. Symptoms at rest/inability to carry out physical activity without discomfort.

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