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http://hdl.handle.net/10553/45957
Title: | Fungal colonization and/or infection in non-neutropenic critically ill patients: Results of the EPCAN observational study | Authors: | León, C. Álvarez-Lerma, F. Ruiz-Santana, S. León, M. Á Nolla, J. Jordá, R. Saavedra, P. Palomar, M. |
UNESCO Clasification: | 32 Ciencias médicas 320505 Enfermedades infecciosas |
Keywords: | Blood-Stream Infections Hospital-Acquired Candidemia Intensive-Care Units Risk-Factors Surgical-Patients, et al |
Issue Date: | 2009 | Journal: | European Journal of Clinical Microbiology and Infectious Diseases | Abstract: | The purpose of this paper is to determine the incidence of fungal colonization and infection in non-neutropenic critically ill patients and to identify factors favoring infection by Candida spp. A total of 1,655 consecutive patients (> 18 years of age) admitted for a parts per thousand yen7 days to 73 medical-surgical Spanish intensive care units (ICUs) participated in an observational prospective cohort study. Surveillance samples were obtained once a week. One or more fungi were isolated in different samples in 59.2% of patients, 94.2% of which were Candida spp. There were 864 (52.2%) patients with Candida spp. colonization and 92 (5.5%) with proven Candida infection. In the logistic regression analysis risk factors independently associated with Candida spp. infection were sepsis (odds ratio [OR] = 8.29, 95% confidence interval [CI] 5.07-13.6), multifocal colonization (OR = 3.49, 95% CI 1.74-7.00), surgery (OR = 2.04, 95% CI 1.27-3.30), and the use of total parenteral nutrition (OR = 4.37, 95% CI 2.16-8.33). Patients with Candida spp. infection showed significantly higher in-hospital and intra-ICU mortality rates than those colonized or non-colonized non-infected (P < 0.001). Fungal colonization, mainly due to Candida spp., was documented in nearly 60% of non-neutropenic critically ill patients admitted to the ICU for more than 7 days. Proven candidal infection was diagnosed in 5.5% of cases. Risk factors independently associated with Candida spp. infection were sepsis, multifocal colonization, surgery, and the use of total parenteral nutrition. | URI: | http://hdl.handle.net/10553/45957 | ISSN: | 0934-9723 | DOI: | 10.1007/s10096-008-0618-z | Source: | European Journal of Clinical Microbiology and Infectious Diseases [ISSN 0934-9723], v. 28, p. 233-242 |
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