Public Defence: Liv Hesstvedt - Medical microbiology and Infectious Diseases
Cand.med. Liv Hesstvedt at Institute of Clinical Medicine will be defending the thesis "Aspects of candidemia in Norway and in the Nordic countries: A contribution to the understanding of epidemiology, clinical aspects and outcome in patients with candidemia" for the degree of PhD
Foto: Øystein Horgmo, UiO
Trial Lecture - time and place
See Trial Lecture.
- First opponent: Professor Paul Verweij, Nijmegen Medical Center, Radboud University, The Netherlands
- Second opponent: Senior Consultant Jannik Helweg-Larsen, Department of Infectious Diseases, Rigshospitalet Copenhagen, Denmark
- Third member and chair of the adjudication committee: Associate Professor Anne-Marte Bakken Kran, Faculty of Medicine, University of Oslo
Chair of the Defence
Professor II Olav Dalgard, Faculty of Medicine, University of Oslo
Associate Professor Ingvild Nordøy, Oslo University Hospital
Blood stream infection with yeast, candidemia, is a rare, but severe condition with high mortality. Candidemia is diagnosed in immuno-compromised hospitalized patients with underlying illnesses. In Norway the incidence has been low, compared to Denmark, where it is 3 times more common, for reasons we do not fully understand.
There are few reports focusing on the epidemiological differences in candidemia in the Nordic countries, as well as long-term epidemiological follow up in Norway. Risk factors for candidemia, treatment practice and outcome in the Norwegian setting are unknown.
The aims of this thesis were to shed light on the epidemiological development of candidemia in Norway over time and differences between the Nordic countries. Through a Nordic collaboration and 2 multicentre studies they assessed risk factors for candidemia, therapeutic practice and outcome by reviewing medical records and laboratory data.
The incidence of candidemia in Norway is low, but slowly increasing, particular in patients over 65 years. Risk factors for candidemia in the elderly were abdominal surgery and malignancy. Patients below 65 years were more often in Intensive Care Units with a CVC, being mechanically ventilated, receiving chemo- and other immune-suppressive therapies than the elderly. Antifungal treatment was given significantly more often to the younger patients than to the elderly, with a lower mortality at 23.9% vs. 45.5% in the elderly.
Higher incidence of haematological malignancies and more frequent use of antibiotics with anti-anaerobic effect can be part of the reason for the high incidence in Denmark compared to the other Nordic countries.
In conclusion, we observed significant differences regarding candidemia according to age-groups. Overall, despite many elderly patients had an underlying cancer, better knowledge of this treatable infection and increased antifungal treatment to the elderly could improve survival.
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