Candidemia in a Canadian tertiary care hospital from 1976 to 1996.

The incidence of candidemia was reviewed at the Health Sciences Centre in Winnipeg, Canada, over a 21-year period (1976 to 1996). Candida species were identified as blood-stream isolates in significantly (p < 0.05) higher numbers from 1991 to 1996 than in the previous 15 years. Antifungal susceptibilities remained unchanged with Candida albicans isolates tested from 1985 to 1996. Retrospective chart reviews revealed that all patients with candidemia possessed at least two risk factors. The main risk factors identified were recent or concurrent antibiotic therapy (95% of patients), presence of a central line (93% of patients), and immunosuppression (88% of patients). Treatment generally involved amphotericin B therapy (81% of patients), and death occurred in 52% of the patients. Mortality directly attributable to Candida species could be established in 23% of patients.