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?tropicalis are poorly defined and usually biased by the selection of specific groups, such as patients with haematological malignancies or solid tumours [14�C16]. In addition, data on incidence and mortality vary with the country and the population studied. We performed the largest single-centre case�Ccontrol study to date of patients with C.?tropicalis fungaemia, in order to define the risk factors and outcome of this condition in an unselected population. We performed a case�Ccontrol study comparing each patient who had had an episode of C.?tropicalis fungaemia with three cases of fungaemia caused by other species in our institution from January 1985 to December 2008. The controls Selleckchem PF-06463922 were matched only by the year of isolation of non-tropicalis Candida species from blood, and were selected from the database by means of a random number table. Ours is a large, general tertiary teaching hospital currently serving a population of approximately 750?000 inhabitants Bafilomycin A1 solubility dmso in Madrid, Spain. The hospital has approximately 1600 beds and all medical and surgical specialties, including solid organ (heart, liver, and kidney) and bone marrow transplant programmes. The medical charts of the patients were retrospectively reviewed according to a pre-established protocol including the following variables: age, sex, underlying diseases, risk factors, clinical presentation, source of fungaemia, antifungal therapy, mortality during admission, and mortality attributable to candidaemia. An episode of candidaemia was defined as at least one blood culture that was positive for Candida. Among underlying diseases, cancer refers to patients with an active tumour at the onset of candidaemia, haematological disease refers to patients with a haematological malignancy at the onset of candidaemia, human immunodeficiency virus (HIV) refers to patients with HIV infection, with or without AIDS, intravenous drug abuse (IVDA) refers to patients who were actively using illicit intravenous drugs at the onset of candidaemia, and transplantation refers to patients who were recipients of haematological or solid organ transplants. Regarding risk factors, neutropenia refers to patients who presented an absolute neutrophil count FMO5 at the onset of candidaemia. Intensive-care unit stay, parenteral nutrition, intravenous lines and bladder catheters were considered to be risk factors if they were present at the onset of candidaemia. Corticosteroid use was assumed to be a risk factor if the patient had received ��20?mg/day of prednisone for ��15?days before the onset of fungaemia. Previous therapy with antimicrobials, antifungals and azoles was defined as the administration of one or more doses of each agent during the 30?days before the onset of candidaemia. Surgery refers to any type of major surgical procedure in the past 3?months. With regard to clinical manifestations, fever was defined as an axillary temperature ��38.3��C.