Risk factors for early invasive fungal disease in critically ill patients

Background: The incidence of invasive fungal disease (IFD) is increasing worldwide in the past two to three decades. Critically ill patients in Intensive Care Units are more vulnerable to fungal infection. Early detection and treatment are important to decrease morbidity and mortality in critically...

Full description

Saved in:
Bibliographic Details
Published in:Indian journal of critical care medicine 2016-11, Vol.20 (11), p.633-639
Main Authors: Singh, Gurmeet, Pitoyo, Ceva, Aditianingsih, Dita, Rumende, Cleopas
Format: Article
Language:English
Subjects:
Antifungal agents
Critical care medicine
Cross infection
Dosage and administration
Indonesia
Mortality
Mycoses
Risk factors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: The incidence of invasive fungal disease (IFD) is increasing worldwide in the past two to three decades. Critically ill patients in Intensive Care Units are more vulnerable to fungal infection. Early detection and treatment are important to decrease morbidity and mortality in critically ill patients. Objective: Our study aimed to assess factors associated with early IFD in critically ill patients. Materials and Methods: This prospective cohort study was conducted in critically ill patients, from March to September 2015. Total number of patients (74) in this study was drawn based on one of the risk factors (human immunodeficiency virus). Specimens were collected on day 5-7 of hospitalization. Multivariate analysis with logistic regression was performed for factors, with P< 0.25 in bivariate analysis. Results: Two hundred and six patients were enrolled in this study. Seventy-four patients were with IFD, majority were males (52.7%), mean age was 58 years (range 18-79), mean Leon's score was 3 (score range 2-5), majority group was nonsurgical/nontrauma (72.9%), and mean fungal isolation was positive on day 5. Candida sp. (92.2%) is the most frquently isolated fungal infection. Urine culture yielded the highest number of fungal isolates (70.1%). Mortality rate in this study was 50%. In multivariate analysis, diabetes mellitus (DM) (P = 0.018, odds ratio 2.078, 95% confidence interval 1.135-3.803) was found as an independent factor associated with early IFD critically ill patients. Conclusion: DM is a significant factor for the incidence of early IFD in critically ill patients.
ISSN:0972-5229
1998-359X
DOI:10.4103/0972-5229.194007