Alexandra Fochtmann1, Christina Forstner2, Michael Hagmann3, Maike Keck4, Gabriela Muschitz5, Elisabeth Presterl6, Gerald Ihra7, Thomas Rath8. 1. Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria. Electronic address: alexandra.fochtmann@meduniwien.ac.at. 2. Medical University of Vienna, Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Vienna, Austria. Electronic address: christina.a.forstner@meduniwien.ac.at. 3. Medical University of Vienna, Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Vienna, Austria. Electronic address: michael.hagmann@meduniwien.ac.at. 4. Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria. Electronic address: maike.keck@meduniwien.ac.at. 5. Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria. Electronic address: gabriela.muschitz@meduniwien.ac.at. 6. Medical University of Vienna, Clinical Institute of Infection Control and Hospital Epidemiology, Vienna, Austria. Electronic address: elisabeth.presterl@meduniwien.ac.at. 7. Medical University of Vienna, Department of Anesthesiology and General Intensive Care, Vienna, Austria. Electronic address: gerald.ihra@meduniwien.ac.at. 8. Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria. Electronic address: thomas.rath@meduniwien.ac.at.
Abstract
BACKGROUND: Despite advances in surgery and critical care, candidemia remains a significant cause of morbidity and mortality in patients with extensive burns. METHODS: A retrospective single-center cohort study was performed on 174 patients admitted to the Burn Intensive Care Unit of the General Hospital of Vienna (2007-2013). An AIC based model selection procedure for logistic regression models was utilized to identify factors associated with the presence of candidemia. RESULTS: Twenty (11%) patients developed candidemia on median day 16 after ICU admission associated with an increased overall mortality (30% versus 10%). Statistical analysis identified the following factors associated with proven candidemia: younger age (years) odds ratio (OR):0.96, 95% confidence interval (95% CI):0.92-1.0, female gender (reference male) OR:5.03, 95% CI:1.25-24.9, gastrointestinal (GI) complications requiring surgery (reference no GI complication) OR:20.37, 95% CI:4.25-125.8, non-gastrointestinal thromboembolic complications (reference no thromboembolic complication) OR:17.3, 95% CI:2.57-170.4 and inhalation trauma (reference no inhalation trauma) OR:7.96, 95% CI:1.4-48.4. CONCLUSIONS: Above-mentioned patient groups are at considerably high risk for candidemia and might benefit from a prophylactic antifungal therapy. Younger age as associated risk factor is likely to be the result of the fact that older patients with a great extent of burn body surface have a lower chance of survival compared to younger patients with a comparable TBSA.
BACKGROUND: Despite advances in surgery and critical care, candidemia remains a significant cause of morbidity and mortality in patients with extensive burns. METHODS: A retrospective single-center cohort study was performed on 174 patients admitted to the Burn Intensive Care Unit of the General Hospital of Vienna (2007-2013). An AIC based model selection procedure for logistic regression models was utilized to identify factors associated with the presence of candidemia. RESULTS: Twenty (11%) patients developed candidemia on median day 16 after ICU admission associated with an increased overall mortality (30% versus 10%). Statistical analysis identified the following factors associated with proven candidemia: younger age (years) odds ratio (OR):0.96, 95% confidence interval (95% CI):0.92-1.0, female gender (reference male) OR:5.03, 95% CI:1.25-24.9, gastrointestinal (GI) complications requiring surgery (reference no GI complication) OR:20.37, 95% CI:4.25-125.8, non-gastrointestinal thromboembolic complications (reference no thromboembolic complication) OR:17.3, 95% CI:2.57-170.4 and inhalation trauma (reference no inhalation trauma) OR:7.96, 95% CI:1.4-48.4. CONCLUSIONS: Above-mentioned patient groups are at considerably high risk for candidemia and might benefit from a prophylactic antifungal therapy. Younger age as associated risk factor is likely to be the result of the fact that older patients with a great extent of burn body surface have a lower chance of survival compared to younger patients with a comparable TBSA.
Authors: Be Nguyen Van Bang; Nguyen Thanh Xuan; Dinh Xuan Quang; Cao Ba Loi; Nguyen Thai Ngoc Minh; Nguyen Nhu Lam; Do Ngoc Anh; Truong Thi Thu Hien; Hoang Xuan Su; Le Tran-Anh Journal: Curr Med Mycol Date: 2020-09
Authors: Ravil M Huseynov; Samir S Javadov; Ali Osmanov; Shahin Khasiyev; Samira R Valiyeva; Esmira Almammadova; David W Denning Journal: Ther Adv Infect Dis Date: 2021-09-03