Nosocomial candidemia in adults: Risk and prognostic factors

Determination of the risk and prognostic factors for candidemias that develop in adult patients (in a general hospital patient population, intensive care unit [ICU] patients and patients with solid organ malignancy). The risk factors for candidemia were investigated in 256 adult patients (≥ 18 years...

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Bibliographic Details
Published in:Journal de mycologie médicale 2010-12, Vol.20 (4), p.269-278
Main Authors: Gürcüoğlu, E., Akalın, H., Ener, B., Ocakoğlu, G., Sınırtaş, M., Akçağlar, Sevim, Yılmaz, E., Evci, C., Oral, B.
Format: Article
Language:eng ; fre
Subjects:
Candida albicans
Candidémie nosocomiale
Facteurs de risque
Mortality
Mortalité
Nosocomial candidemia
Risk factors
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Summary:Determination of the risk and prognostic factors for candidemias that develop in adult patients (in a general hospital patient population, intensive care unit [ICU] patients and patients with solid organ malignancy). The risk factors for candidemia were investigated in 256 adult patients (≥ 18 years old). The risk and prognostic factors for candidemia were investigated in adult patients using a matched case-control design. We found that a total of 457 adult patients developed nosocomial candidemia in our hospital over the 12-year study period. Candida albicans (46.8%) was the most common etiological agent in candidemia, whereas C. parapsilosis (27%) was isolated as the second most frequent species. The ratio of C. glabrata was 3.8%. The risk factors for candidemia were investigated in 256 patients for whom full medical record information was available. Total parenteral nutrition (TPN) (OR 1.718; 95% CI 1.139–2.594, P = 0.01), antacid use (OR 1.841; 95% CI 1.239–2.735, P = 0.003) and candiduria (OR 2.095; 95% CI 1.213–3.617, P = 0.008) were detected as independent risk factors for candidemia among all affected patients. Removal of the central venous catheter (OR 1.976; 95% CI 1.219–3.202, P = 0.006) was protective against mortality. Candiduria, and use of TPN were the most frequently encountered independent risk factors in almost all patient groups in our study as well as in other studies on this topic, so they should be taken into account in the evaluation of patients with suspicion of candidemia. Détermination des facteurs de risque et de pronostic dans les candidémies chez des patients adultes (en ICU ou atteints de cancer hospitalisés dans l’hôpital Général). Les facteurs de risque de candidémies ont été étudiés chez 256 patients adultes (≥ 18 ans) en utilisant une méthode assortie de cas-témoin. Nous avons constaté qu’un total de 457 patients adultes ont développé une candidémie nosocomiale dans notre hôpital au cours d’une période d’étude de 12 ans. Candida albicans (46,8 %) était l’agent étiologique le plus commun et C. parapsilosis (27 %) a été isolé comme la seconde espèce la plus fréquente. La proportion de C. glabrata était de 3,8 %. Les facteurs de risque ont été étudiés chez 256 patients pour qui les informations complètes du rapport médical étaient disponibles. La nutrition parentérale totale (TPN) (OU 1,718 ; 95 % CI 1,139–2,594, p = 0,01), l’utilisation d’antiacide (OU 1,841 ; 95 % CI 1,239–2,735, p = 0,003) et la candidurie (OU 2,095 de 95 
ISSN:1156-5233
1773-0449
DOI:10.1016/j.mycmed.2010.07.006