OBJECTIVE: The objective of this study was to determine the clinical features associated with candidemia caused by non-albicans Candida spp. and with potentially fluconazole-resistant Candida spp. (C. glabrata and C. krusei) among candidemic intensive care unit patients. DESIGN: The authors conducted a nationwide prospective cohort study. SETTING: The study was conducted in Australian intensive care units. PATIENTS: All patients with intensive care unit-acquired candidemia over a 3-yr period were included in the study. MEASUREMENTS: Clinical risk factors occurring up to 30 days before candidemia, Candida spp. associated with candidemia, and outcomes were determined. Risk factors associated with either non-albicans Candida spp. or with potentially fluconazole-resistant Candida spp. (C. glabrata or C. krusei) were assessed using multivariate logistic regression. MAIN RESULTS: Among 179 episodes of intensive care unit-acquired candidemia, C. albicans accounted for 62%, C. glabrata 18%, C. krusei 4%, and other Candida spp. 16%. Independently significant variables associated with non-albicans Candida bloodstream infection included recent prior gastrointestinal surgery (adjusted odds ratio, 2.87; 95% confidence interval, 1.68-4.91) and recent prior systemic antifungal exposure (4.6; 1.36-15.53). Those associated with potentially fluconazole-resistant candidemia included recent prior gastrointestinal surgery (3.31; 1.79-6.11) and recent prior fluconazole exposure (5.47; 1.23-24.32). No significant differences in outcomes were demonstrated for non-albicans or potentially fluconazole-resistant candidemia. CONCLUSIONS: Among candidemic intensive care unit patients, prior gastrointestinal surgery and systemic antifungal exposure were significantly associated with both a non-albicans Candida spp. and a potentially fluconazole-resistant Candida spp.
OBJECTIVE: The objective of this study was to determine the clinical features associated with candidemia caused by non-albicans Candida spp. and with potentially fluconazole-resistant Candida spp. (C. glabrata and C. krusei) among candidemic intensive care unit patients. DESIGN: The authors conducted a nationwide prospective cohort study. SETTING: The study was conducted in Australian intensive care units. PATIENTS: All patients with intensive care unit-acquired candidemia over a 3-yr period were included in the study. MEASUREMENTS: Clinical risk factors occurring up to 30 days before candidemia, Candida spp. associated with candidemia, and outcomes were determined. Risk factors associated with either non-albicans Candida spp. or with potentially fluconazole-resistant Candida spp. (C. glabrata or C. krusei) were assessed using multivariate logistic regression. MAIN RESULTS: Among 179 episodes of intensive care unit-acquired candidemia, C. albicans accounted for 62%, C. glabrata 18%, C. krusei 4%, and other Candida spp. 16%. Independently significant variables associated with non-albicans Candida bloodstream infection included recent prior gastrointestinal surgery (adjusted odds ratio, 2.87; 95% confidence interval, 1.68-4.91) and recent prior systemic antifungal exposure (4.6; 1.36-15.53). Those associated with potentially fluconazole-resistant candidemia included recent prior gastrointestinal surgery (3.31; 1.79-6.11) and recent prior fluconazole exposure (5.47; 1.23-24.32). No significant differences in outcomes were demonstrated for non-albicans or potentially fluconazole-resistant candidemia. CONCLUSIONS: Among candidemic intensive care unit patients, prior gastrointestinal surgery and systemic antifungal exposure were significantly associated with both a non-albicans Candida spp. and a potentially fluconazole-resistant Candida spp.
Authors: Ashraf Elhoufi; Arezoo Ahmadi; Amir Mohammad Hashem Asnaashari; Mohammad Ali Davarpanah; Behrooz Farzanegan Bidgoli; Omid Moradi Moghaddam; Mohammad Torabi-Nami; Saeed Abbasi; Malak El-Sobky; Ali Ghaziani; Mohammad Hossein Jarrahzadeh; Reza Shahrami; Farzad Shirazian; Farhad Soltani; Homeira Yazdinejad; Farid Zand Journal: World J Crit Care Med Date: 2014-11-04
Authors: L X Bonfietti; M W Szeszs; M R Chang; M A Martins; S R B S Pukinskas; M O Nunes; G H Pereira; A M M Paniago; S U Purisco; M S C Melhem Journal: Mycopathologia Date: 2012-07-21 Impact factor: 2.574
Authors: Y Wang; Q Yang; L Chen; L Liu; R Hao; T Zhang; X Wang; J Lei; J Xie; Y Dong Journal: Eur J Clin Microbiol Infect Dis Date: 2017-06-15 Impact factor: 3.267
Authors: I D Jacobsen; S Brunke; K Seider; T Schwarzmüller; A Firon; C d'Enfért; K Kuchler; B Hube Journal: Infect Immun Date: 2009-12-14 Impact factor: 3.441
Authors: C Lichtenstern; S Swoboda; M Hirschburger; E Domann; T Hoppe-Tichy; M Winkler; C Lass-Flörl; M A Weigand Journal: Anaesthesist Date: 2010-01 Impact factor: 1.041