Abstract
Candidaemia carries a mortality of up to 40% and may be related to increasing complexity of medical care. Here, we determined risk factors for the development of candidaemia. We conducted a prospective, multi-centre, case-control study over 12months. Cases were aged ≥18years with at least one blood culture positive for Candida spp. Each case was matched with two controls, by age within 10years, admission within 6months, admitting unit, and admission duration at least as long as the time between admission and onset of candidaemia. A total of 118 incident cases and 236 matched controls were compared. By multivariate analysis, risk factors for candidaemia included neutropenia, solid organ transplant, significant liver, respiratory or cardiovascular disease, recent gastrointestinal, biliary or urological surgery, central venous access device, intravenous drug use, urinary catheter and carbapenem receipt. Risk factors for candidaemia derive from the infection source, carbapenem use, host immune function and organ-based co-morbidities. Preventive strategies should target iatrogenic disruption of mucocutaneous barriers and intravenous drug use.
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