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dc.contributor.authorAsmundsdóttir, L R
dc.contributor.authorErlendsdóttir, H
dc.contributor.authorGísladóttir, A L
dc.contributor.authorGottfredsson, M
dc.date.accessioned2012-08-09T11:36:29Z
dc.date.available2012-08-09T11:36:29Z
dc.date.issued2012-02
dc.date.submitted2012-08-09
dc.identifier.citationClin. Microbiol. Infect. 2012, 18(2):195-201en_GB
dc.identifier.issn1469-0691
dc.identifier.pmid21733031
dc.identifier.doi10.1111/j.1469-0691.2011.03595.x
dc.identifier.urihttp://hdl.handle.net/2336/237951
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links field.en_GB
dc.description.abstractCandidaemia is associated with high patient mortality. Among those who survive an initial episode of candidaemia, the incidence of recurrent episodes has been incompletely defined. All patients in Iceland with candidaemia in 1980-2008 were identified, and clinical information was reviewed. Episodes of candidaemia in the same patient were considered to be separate if they occurred ≥ 1 month apart or were caused by different Candida species. The isolates were genotyped by using PCR fingerprinting, and antifungal susceptibility was determined. During the 29-year period, candidaemia was diagnosed in 307 patients in Iceland, 298 of whom (97.1%) had a single episode. Overall, 206 patients survived >1 month from the first episode and were therefore at risk of recurrence, yielding 1062 patient-years of observation in the survivors. Of those, nine (4.4%) later developed recurrent candidaemia. The median time between recurrences was 6 months (range, <1 month to 14 years). Patients with late recurrences were younger (p 0.012) and more likely to have underlying gastrointestinal diseases than patients with single episodes (55.6% vs. 18.5%, respectively; p 0.017). The recurrences were caused by identical Candida sp. genotypes in two of 13 cases (15%), but by different species or dissimilar genotypes in eight of 13 (62%); isolates were missing in three cases. In conclusion, late recurrent candidaemia was a relatively rare event, and younger patients with gastrointestinal disorders were more prone to recurrent infections. The majority of late recurrences represented re-infections with new Candida strains that were susceptible to common antifungal agents.
dc.description.sponsorshipLandspitali University Hospitalen_GB
dc.language.isoenen
dc.relation.urlhttp://dx.doi.org/10.1111/j.1469-0691.2011.03595.xen_GB
dc.rightsArchived with thanks to Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseasesen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshAntifungal Agentsen_GB
dc.subject.meshCandidaen_GB
dc.subject.meshCandidemiaen_GB
dc.subject.meshChilden_GB
dc.subject.meshChild, Preschoolen_GB
dc.subject.meshDNA Fingerprintingen_GB
dc.subject.meshDNA, Fungalen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshGenotypeen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIcelanden_GB
dc.subject.meshIncidenceen_GB
dc.subject.meshInfanten_GB
dc.subject.meshInfant, Newbornen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMicrobial Sensitivity Testsen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshMolecular Epidemiologyen_GB
dc.subject.meshMolecular Typingen_GB
dc.subject.meshMycological Typing Techniquesen_GB
dc.subject.meshPolymerase Chain Reactionen_GB
dc.subject.meshRecurrenceen_GB
dc.subject.meshYoung Adulten_GB
dc.titleMolecular epidemiology of late recurrent candidaemia--a population-based study in Iceland.en
dc.typeArticleen
dc.contributor.departmentDepartment of Infectious Diseases, Landspitali University Hospital, Reykjavik, Iceland.en_GB
dc.identifier.journalClinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseasesen_GB
dc.rights.accessLandspitali Access - LSH-aðganguren
dc.type.categorySýklad, Smitsjúkd, Lífeindafren_GB
html.description.abstractCandidaemia is associated with high patient mortality. Among those who survive an initial episode of candidaemia, the incidence of recurrent episodes has been incompletely defined. All patients in Iceland with candidaemia in 1980-2008 were identified, and clinical information was reviewed. Episodes of candidaemia in the same patient were considered to be separate if they occurred ≥ 1 month apart or were caused by different Candida species. The isolates were genotyped by using PCR fingerprinting, and antifungal susceptibility was determined. During the 29-year period, candidaemia was diagnosed in 307 patients in Iceland, 298 of whom (97.1%) had a single episode. Overall, 206 patients survived >1 month from the first episode and were therefore at risk of recurrence, yielding 1062 patient-years of observation in the survivors. Of those, nine (4.4%) later developed recurrent candidaemia. The median time between recurrences was 6 months (range, <1 month to 14 years). Patients with late recurrences were younger (p 0.012) and more likely to have underlying gastrointestinal diseases than patients with single episodes (55.6% vs. 18.5%, respectively; p 0.017). The recurrences were caused by identical Candida sp. genotypes in two of 13 cases (15%), but by different species or dissimilar genotypes in eight of 13 (62%); isolates were missing in three cases. In conclusion, late recurrent candidaemia was a relatively rare event, and younger patients with gastrointestinal disorders were more prone to recurrent infections. The majority of late recurrences represented re-infections with new Candida strains that were susceptible to common antifungal agents.


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