Abstract
The aim of the study was to describe the microbiology and susceptibility profile of candidemia and to identify the risk factors associated with mortality in Colombia. A cohort of patients was followed for 30 days during 2008 to 2010. Microbiological identification and susceptibility assessments were performed in a reference centre. Demographic, clinical and treatment variables were evaluated for their associations with mortality. A parametric survival regression analysis was used to identify the risk factors associated with mortality. A total of 109 patients with candidemia in four hospitals in Colombia were identified, with a median age of 30 years old. C. parapsilosis was the most frequently identified microorganism (38.5%); the susceptibility of all isolates was high to fluconazole and anidulafungin, except for C. glabrata isolates. The overall mortality was 35.7%, and the risk factors associated with mortality included lack of antifungal treatment (HR 5.5, 95% CI 3.6-11.4), cancer (HR 3.9, 95% CI 2.3-8.0), diabetes (HR 2.5, 95% CI 1.03-6.4), and age (HR 1.13 per every 10 years, 95% CI 1.02-1.24). Catheter removal was associated with a low mortality rate (HR 0.06, 95% CI 0.00-0.49). Prompt antifungal treatment, better glycemic control and catheter removal should be prioritized in the management of candidemia.