National Epidemiology of Mycoses Survey (NEMIS): Variations in rates of bloodstream infections due to Candida species in seven surgical intensive care units and six neonatal intensive care units

Candida species are the fourth most frequent cause of nosocomial bloodstrea m infections, and 25%-50% occur in critical care units. During an 18-month prospective study period, all patients admitted for greater than or equal t o 72 hours to the surgical (SICUs) or neonatal intensive care units (NICUs) at each of the participant institutions were followed daily, Among 4,276 p atients admitted to the seven SICUs in six centers, there were 42 nosocomia l bloodstream infections due to Candida species (9.8/1,000 admissions; 0.99 /1,000 patient-days). Of 2,847 babies admitted to the six NICUs, 35 acquire d a nosocomial bloodstream infection due to Candida species (12.3/1,000 adm issions; 0.64/1,000 patient-days). The following were the most commonly iso lated Candida species causing bloodstream infections in the SICU: Candida a lbicans, 48%; Candida glabrata, 24%; Candida tropicalis, 19%; Candida parap silosis, 7%; Candida species not otherwise specified, 2%. In the NICU the d istribution was as follows: C. albicans, 63%; C. glabrata, 6%; C, parapsilo sis, 29%; other, 3%, Of the patients, 30%-50% developed incidental stool co lonization, 23% of SICU patients developed incidental urine colonization, a nd one-third of SICU health care workers' hands were positive for Candida s pecies.