التفاصيل البيبلوغرافية
| العنوان: |
Invasive Candida infections in surgical patients in intensive care units: a prospective, multicentre survey initiated by the European Confederation of Medical Mycology (ECMM) (2006-2008). |
| المؤلفون: |
Klingspor, L.1, Tortorano, A. M.2, Peman, J.3, Willinger, B.4, Hamal, P.5, Sendid, B.6, Velegraki, A.7, Kibbler, C.8, Meis, J. F.9,10, Sabino, R.11, Ruhnke, M.12, Arikan-Akdagli, S.13, Salonen, J.14, Dóczi, I.15 lena.klingspor@ki.se |
| المصدر: |
Clinical Microbiology & Infection. Jan2015, Vol. 21 Issue 1, p87.e1-87.e10. 10p. |
| مصطلحات موضوعية: |
*INVASIVE candidiasis, *INFECTION, *SURGICAL intensive care, *ABDOMINAL surgery, *LONGITUDINAL method, *MEDICAL mycology, *VORICONAZOLE, *FLUCONAZOLE, *PATIENTS, *THERAPEUTICS |
| مستخلص: |
A prospective, observational, multicentre study of invasive candidosis (IC) in surgical patients in intensive care units (ICUs) was conducted from 2006 to 2008 in 72 ICUs in 14 European countries. A total of 779 patients (62.5% males, median age 63 years) with IC were included. The median rate of candidaemia was 9 per 1000 admissions. In 10.8% the infection was already present at the time of admission to ICU. Candida albicans accounted for 54% of the isolates, followed by Candida parapsilosis 18.5%, Candida glabrata 13.8%, Candida tropicalis 6%, Candida krusei 2.5%, and other species 5.3%. Infections due to C. krusei (57.9%) and C. glabrata (43.6%) had the highest crude mortality rate. The most common preceding surgery was abdominal (51.5%), followed by thoracic (20%) and neurosurgery (8.2%). Candida glabrata was more often isolated after abdominal surgery in patients ⩾60 years, and C. parapsilosis was more often isolated in neurosurgery and multiple trauma patients as well as children ⩽1 year of age. The most common first-line treatment was fluconazole (60%), followed by caspofungin (18.7%), liposomal amphotericin B (13%), voriconazole (4.8%) and other drugs (3.5%). Mortality in surgical patients with IC in ICU was 38.8%. Multivariate analysis showed that factors independently associated with mortality were: patient age ⩾60 years (hazard ratio (HR) 1.9, p 0.001), central venous catheter (HR 1.8, p 0.05), corticosteroids (HR 1.5, p 0.03), not receiving systemic antifungal treatment for IC (HR 2.8, p <0.0001), and not removing intravascular lines (HR 1.6, p 0.02). [ABSTRACT FROM AUTHOR] |
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