Changes in clinical features of fungemia in a Japanese University Hospital over a 12-year period.

Forty-five patients with fungemia during 1982-1993 (periods I = 1982, II = 1986-1989, III = 1990-1993) in a Japanese university hospital were reviewed to follow changes in the clinical features of fungemia. The percentage of fungi among microorganisms isolated from blood cultures was almost constant (6-10%) throughout the study period. Fungemia was highly associated with use of intravascular catheters, and some changes in clinical features were observed: 1) Candida albicans, C. parapsilosis and C. glabrata were the main isolates, and the number of fungal species showed a tendency to increase. 2) The percentage of patients over 65 years old increased from 36 to 50%. 3) The percentage of patients who were treated with anti-fungal agents and/or removal of catheter increased from 50 to 89 and to 86%. 4) The percentage of patients who died within 28 days after isolation of fungus decreased from 64 to 27%. The improved prognosis was thought to be due to the development of new anti-fungal agents and faster removal of intravascular catheter when infection was suspected.