Risk factors for candidemia in non-neutropenic critical patients in Colombia

被引:23
作者
Ortiz Ruiz, G. [1 ]
Osorio, J. [2 ]
Valderrama, S. [3 ]
Alvarez, D. [4 ]
Elias Diaz, R. [5 ]
Calderon, J. [6 ]
Ballesteros, D. [7 ]
Franco, A. [8 ]
机构
[1] Univ Bosquec, Hosp Santa Clara, Dept Cuidados Intens, Bogota, Colombia
[2] Univ Dept Med Interna Surcolombiana, Neiva, Colombia
[3] Pontificia Univ Javeriana, Dept Med Interna, Bogota, Colombia
[4] Univ Pittsburgh, Med Ctr, Dept Med Interna Pittsburgh, Pittsburgh, PA 15260 USA
[5] Dept Med Interna Fdn Clin Shaio, Bogota, Colombia
[6] Hosp Univ Neiva, Dept Med Interna Neiva, Neiva, Colombia
[7] Hosp Santa Clara, Dept Med Interna, Bogota, Colombia
[8] Hosp Santa Clara, Dept Cuidados Intens, Bogota, Colombia
关键词
Candida; Risk factors; Mortality; Intensive care; Invasive candidiasis; CLINICAL-PREDICTION RULES; INTENSIVE-CARE-UNIT; INVASIVE CANDIDIASIS; ILL PATIENTS; ATTRIBUTABLE MORTALITY; EPIDEMIOLOGY; SCORE; MULTICENTER; VALIDATION; COLONIZATION;
D O I
10.1016/j.medin.2015.08.001
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objectives: Due to the increase in isolation of Candida spp. in critically ill patients, and the high mortality and economic costs which this infection entails, a study was made of the risk factors associated to candidemia in critically ill patients from 7 intensive care units in Colombia. Materials and methods: A multicenter matched case-control study was conducted in 7 intensive care units of 3 university hospitals. Data on overall length of hospital stay (including both general wards and the intensive care unit) were recorded. Results: A total of 243 subjects (81 cases and 162 controls) between January 2008 and December 2012 were included. In order of frequency, C. albicans, C. tropicalis and C. parapsilosis were isolated. The main identified risk factors were: overall length of hospital stay > 25 days (OR 5.33, 95% CI 2.6-10.9), use of meropenem (OR 3.75, 95% CI 1.86-7.5), abdominal surgery (OR 2.9, 95% CI 1.39-6.06) and hemodialysis (OR 3.35, 95% CI 1.5-7.7). No differences in mortality between patients with candidemia and controls were found (39.5 vs. 36.5%, respectively, P=.66) were found. Conclusions: In Colombia, a long hospital stay, abdominal surgery, the use of meropenem and hemodialysis were identified as risk factors for candidemia. (C) 2015 Elsevier Espana, S.L.U. and SEMICYUC. All rights reserved.
引用
收藏
页码:139 / 144
页数:6
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