Time to positive culture and identification for Candida blood stream infections

被引:77
作者
Fernandez, Julianna
Erstad, Brian L.
Petty, Wanda
Nix, David E. [1 ]
机构
[1] Univ Arizona, Coll Pharm & Med, Dept Pharm Practice & Sci, Tucson, AZ 85721 USA
关键词
Time delay; Candida; Blood stream; MORTALITY; FLUCONAZOLE; BACTEC-9240; GUIDELINES; GROWTH; IMPACT;
D O I
10.1016/j.diagmicrobio.2009.04.002
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Candidemia and delay to appropriate therapy contribute to increased morbidity and mortality. Current literature addresses the delay between blood culture collection and final identification; however, it fails to delineate differences among species. The purpose of this study was to quantify the time to yeast detection and identification relative to blood culture collection and determine whether differences exist among species. In this retrospective Study, all cases of Candida isolation for 2 years were reviewed. The time delays between blood culture and detection of Candida growth were quantified as well as the additional time required for final species identification. Initiation of antifungal therapy was assessed in relation to culture collection, detection of yeast, and final identification. The appropriateness of therapy at each time point was also analyzed. Most Candida infections were caused by either Candida albicans (n = 43) or Candida glabrata (n = 27). Mean time to positive yeast detection for C. albicans was 35.3 +/- 18.1 h, whereas that of C glabrata was 80.0 +/- 22.4 h (P < 0.0001). Mean time to final identification for C. albicans was 85.8 +/- 30.9, whereas that of C. glabrata was 154 +/- 43.8 h (P < 0.0001). Mean time to appropriate therapy for C. albicans isolates was 43.3 +/- 27.6 It compared with 98.1 +/- 38.3 h (P < 0.0001) for C. glabrata isolates. The time delay between blood culture collection and yeast detection as well as final identification was significantly longer for C. glabrata isolates when compared with C. albicans. As a result, mean time to appropriate antifungal therapy was significantly longer in patients with C. glabrata isolates. (C) 2009 Elsevier Inc. All rights reserved.
引用
收藏
页码:402 / 407
页数:6
相关论文
共 16 条
  • [1] Bloodstream infections:: A trial of the impact of different methods of reporting positive blood culture results
    Bouza, E
    Sousa, D
    Muñoz, P
    Rodríguez-Créixems, M
    Fron, C
    Lechuz, JG
    [J]. CLINICAL INFECTIOUS DISEASES, 2004, 39 (08) : 1161 - 1169
  • [2] PREDICTION OF CREATININE CLEARANCE FROM SERUM CREATININE
    COCKCROFT, DW
    GAULT, MH
    [J]. NEPHRON, 1976, 16 (01) : 31 - 41
  • [3] Time to initiation of fluconazole therapy impacts mortality in patients with candidemia: A multi-institutional study
    Garey, Kevin W.
    Rege, Milind
    Pai, Manjunath P.
    Mingo, Dana E.
    Suda, Katie J.
    Turpin, Robin S.
    Bearden, David T.
    [J]. CLINICAL INFECTIOUS DISEASES, 2006, 43 (01) : 25 - 31
  • [4] Effect of inoculum size on detection of Candida growth by the BACTEC 9240 automated blood culture system using aerobic and anaerobic media
    George, BJ
    Horvath, LL
    Hospenthal, DR
    [J]. JOURNAL OF CLINICAL MICROBIOLOGY, 2005, 43 (01) : 433 - 435
  • [5] Attributable mortality of nosocomial candidemia, revisited
    Gudlaugsson, O
    Gillespie, S
    Lee, K
    Berg, JV
    Hu, JF
    Messer, S
    Herwaldt, L
    Pfaller, M
    Diekema, D
    [J]. CLINICAL INFECTIOUS DISEASES, 2003, 37 (09) : 1172 - 1177
  • [6] Direct comparison of the BACTEC 9240 and BacT/ALERT 3D automated blood culture systems for Candida growth detection
    Horvath, LL
    George, BJ
    Murray, CK
    Harrison, LS
    Hospenthal, DR
    [J]. JOURNAL OF CLINICAL MICROBIOLOGY, 2004, 42 (01) : 115 - 118
  • [7] 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer
    Hughes, WT
    Armstrong, D
    Bodey, GP
    Bow, EJ
    Brown, AE
    Calandra, T
    Feld, R
    Pizzo, PA
    Rolston, KVI
    Shenep, JL
    Young, LS
    [J]. CLINICAL INFECTIOUS DISEASES, 2002, 34 (06) : 730 - 751
  • [8] ICU-acquired nosocomial infection:: Impact of delay of adequate antibiotic treatment
    Mathevon, T
    Souweine, B
    Traoré, O
    Aublet, B
    Caillaud, D
    [J]. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES, 2002, 34 (11) : 831 - 835
  • [9] Excess mortality, hospital stay, and cost due to candidemia: A case-control study using data from population-based candidemia surveillance
    Morgan, J
    Meltzer, MI
    Plikaytis, BD
    Sofair, AN
    Huie-White, S
    Wilcox, S
    Harrison, LH
    Seaberg, EC
    Hajjeh, RA
    Teutsch, SM
    [J]. INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2005, 26 (06) : 540 - 547
  • [10] Delaying the empiric treatment of Candida bloodstream infection until positive blood culture results are obtained:: a potential risk factor for hospital mortality
    Morrell, M
    Fraser, VJ
    Kollef, MH
    [J]. ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2005, 49 (09) : 3640 - 3645