Document Detail


Mortality rates and risk factors associated with nosocomial Candida infection in a respiratory intensive care unit.
MedLine Citation:
PMID:  20517727     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine the incidence and mortality rate of nosocomial Candida infections (NCI) with respect to associated risk factors in the respiratory intensive care unit (RICU) patients. Data of 163 RICU patients were analyzed for NCI in 2006 retrospectively. Diagnosis of NCI; at least one Candida spp. was isolated in patients with severe sepsis, hospitalized > 1 day intensive care unit (ICU). NCI positive vs. NCI negative were compared with respect to invasive procedure, comorbidities, mortality. Risk factors were analyzed by logistic regression test. NCI positive in 26 (15.9%) patients were mean age: 65 +/- 15 years (female/male ratio: 8/18). Candida albicans/non-albicans ratio was 13/13. ICU stay was longer in NCI positive than NCI negative (48.2 +/- 7.5 days vs. 10.3 +/- 0.8 days; p< 0.001). Higher mortality rates were demonstrated in NCI positive (14.6% vs. 30.8%; p< 0.05). Risk factors for NCI were as follow: Invasive mechanical ventilations (IMV), central catheters and related infections, total parenteral nutrition, multiple antibiotics, ventilator associated tracheobronchitis (VAT) (p< 001 for all and, odd ratio: 95% CI: 6.27, 2.05-19.16; 28.3, 4.61-32.04; 10.93, 4.04-29.56; 2.12-88.98; 14.99, 5.6-40.08, respectively) and sepsis and ventilator associated pneumonia (VAP) (p< 0.01, 7.34, 1.66-32.35; 3.87, 1.42-10.52, respectively). Presence of catheters and related infections, IMV, multiple antibiotics use, parenteral nutrition, VAT, sepsis and VAP were founded as major risk factors for our patients with NCI. Because of longer ICU duration and higher mortality in NCI patients with treated antifungal drugs, risk factors must be evaluated carefully in the ICU.
Authors:
Nalan Adigüzel; Zuhal Karakurt; Gökay Güngör; Ozlem Yazicioğlu Moçin; Eylem Acartürk; Ozlem Soğukpinar; Reha Baran
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Tüberküloz ve toraks     Volume:  58     ISSN:  0494-1373     ISO Abbreviation:  Tuberk Toraks     Publication Date:  2010  
Date Detail:
Created Date:  2010-06-02     Completed Date:  2010-09-30     Revised Date:  2011-03-29    
Medline Journal Info:
Nlm Unique ID:  0417364     Medline TA:  Tuberk Toraks     Country:  Turkey    
Other Details:
Languages:  eng     Pagination:  35-43     Citation Subset:  IM    
Affiliation:
Respiratory Intensive Care Unit, Süreyyapaşa Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antifungal Agents / therapeutic use*
Candidiasis / drug therapy,  epidemiology,  mortality*
Cross Infection / drug therapy,  epidemiology,  mortality*
Female
Hospital Mortality*
Humans
Incidence
Length of Stay
Logistic Models
Male
Middle Aged
Respiratory Care Units / statistics & numerical data*
Retrospective Studies
Risk Factors
Chemical
Reg. No./Substance:
0/Antifungal Agents

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