Mortality and risk factor analysis for Candida blood stream infection: A three-year retrospective study - 01/09/20
, S. Kaya a, B. Ormen b, A. Aksoy Gokmen a, C. Varer Akpinar c, S. Yurtsever Gul aBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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Highlights |
• | Candida parapsilosis was the most frequent causative agent in patients with candidemia. |
• | Dialysis and concurrent bacteremia are strong predictors of mortality within 30 days in patients with candidemia. |
• | Follow-up blood cultures have a protective role with lower mortality rates within 30 days in patients with candidemia. |
Abstract |
Background |
The aim of this study was to evaluate the possible risk factors for mortality in adult patients with candidemia by investigating the causative agents, underlying conditions and predisposing factors.
Material and methods |
The data including causative Candida species, predisposing factors, and underlying conditions of candidemia patients between the years 2015–2017 were collected and the impact of these factors on mortality was evaluated. Patients were divided into two groups as died (died patients within 30 days of the onset of candidemia) and survived and risk factors were evaluated for each group.
Results |
We found 163 adult candidemia cases during the study period. Overall 30-day mortality was 40.5%. Candida parapsilosis was the most frequent causative agent (49.1%). C. parapsilosis candidemia was more common in the survived group compared with the died group (n: 49 (61.3%) vs. n: 31 (38.8%), P=0.888). Mortality rates were significantly higher in patients with dialysis (n: 27 (69.2%) vs. n: 12 (30.8%), P<0.00) and concurrent bacteremia (n: 20 (57.1%) vs. n: 15 (42.9%), P=0.024). Survival rates were significantly higher in patients with follow-up blood cultures (n: 75 (65.8%) vs. n: 39 (34.2%), P=0.013). The most important source of candidemia was catheter (49.7%), and C. parapsilosis was the most common causative agent (58%). The catheter was removed in 96.3% of these patients and the mortality rate was 38.5%. All of the patients received antifungal therapy and there was no significant difference between the effects of antifungals on mortality (n: 65 (39.9%) vs. 98 (60.1%), P=0.607).
Conclusions |
Dialysis and concurrent bacteremia are strong predictors of mortality in 30 days within patients with candidemia, whereas follow-up blood cultures have a protective role with lower mortality rates. In our study, the most important source of candidemia was catheter, and C. parapsilosis was the most common causative agent. The catheter was removed in almost all patients and the mortality rate was almost one third among these patients.
El texto completo de este artículo está disponible en PDF.Keywords : Candida, Candidemia, Predisposing conditions, Underlying conditions, Mortality
Esquema
Vol 30 - N° 3
Artículo 101008- septembre 2020 Regresar al número
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Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
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Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
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