Trends in Antifungal Use and Epidemiology of Nosocomial Yeast Infections in a University Hospital
AUTOR(ES)
Berrouane, Yasmina F.
FONTE
American Society for Microbiology
RESUMO
This report describes both the trends in antifungal use and the epidemiology of nosocomial yeast infections at the University of Iowa Hospitals and Clinics between fiscal year (FY) 1987–1988 and FY 1993–1994. Data were gathered retrospectively from patients’ medical records and from computerized databases maintained by the Pharmacy, the Program of Hospital Epidemiology, and the Medical Records Department. After fluconazole was introduced, use of ketoconazole decreased dramatically but adjusted use of amphotericin B decreased only moderately. However, the proportion of patients receiving antifungal therapy who were treated with amphotericin B declined markedly. In FY 1993–1994, 26 patients of the gastrointestinal surgery service received fluconazole. Among these patients, fluconazole use was prophylactic in 16 (61%), empiric in 3 (12%), and directed to a documented fungal infection in 7 (27%). Rates of nosocomial yeast infection in the adult bone marrow transplant unit increased from 6.77/1,000 patient days in FY 1987–1988 to 10.18 in FY 1989–1990 and then decreased to 0 in FY 1992–1993. Rates of yeast infections increased threefold in the medical and surgical intensive care units, reaching rates in FY 1993–1994 of 6.95 and 5.25/1,000 patient days, respectively. The rate of bloodstream infections increased from 0.044/1,000 patient days to 0.098, and the incidence of catheter-related urinary tract infections increased from 0.23/1,000 patient days to 0.68. Although the proportion of infections caused by yeast species other than Candida albicans did not increase consistently, C. glabrata became an important nosocomial pathogen.
ACESSO AO ARTIGO
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=84452Documentos Relacionados
- Daily antibiotic cost of nosocomial infections in a Turkish university hospital
- Use of molecular epidemiology to monitor the nosocomial dissemination of methicillin-resistant Staphylococcus aureus in a University Hospital from 1991 to 2001
- Epidemiology of nosocomial fungal infections.
- Nosocomial bloodstream infections: organisms, risk factors and resistant phenotypes in the Brazilian University Hospital
- Nasal Carriage of Staphylococcus aureus and Epidemiology of Surgical-Site Infections in a Sudanese University Hospital