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Candida  is an important cause of bloodstream infections (BSI), causing significant mortality and morbidity in health care settings. From January 2008 to December 2010 all consecutive patients who developed candidemia at San Martino University Hospital, Italy were enrolled in the study. A total of 348 episodes of candidaemia were identified during the study period (January 2008–December 2010), with an incidence of 1,73 episodes/1000 admissions. Globally,  albicans  and non- albicans  species caused around 50% of the cases each. Non- albicans  included  Candida parapsilosis  (28.4%),  Candida glabrata  (9.5%),  Candida tropicalis  (6.6%), and  Candida krusei  (2.6%). Out of 324 evaluable patients, 141 (43.5%) died within 30 days from the onset of candidemia.  C. parapsilosis  candidemia was associated with the lowest mortality rate (36.2%). In contrast, patients with  C. krusei  BSI had the highest mortality rate (55.5%) in this cohort. Regarding the crude mortality in the different units, patients in Internal Medicine wards had the highest mortality rate (54.1%), followed by patients in ICU and Hemato-Oncology wards (47.6%).  This report shows that candidemia is a significant source of morbidity in Italy, with a substantial burden of disease, mortality, and likely high associated costs. Although our high rates of candidemia may be related to high rates of BSI in general in Italian public hospitals, reasons for these high rates are not clear and warrant further study. Determining factors associated with these high rates may lead to identifying measures that can help to prevent disease.

Epidemiology, Species Distribution, Antifungal Susceptibility and Outcome of Nosocomial Candidemia in a Tertiary Care Hospital in Italy