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Candida albicans versus non-albicans bloodstream infection in critically ill patients: differences in risk factors and outcome

Abstract number: 1733_767

Dimopoulos G., Ntziora F., Rachiotis G., Armaganidis A., Falagas M.E.

Objective: To identify differences of the risk factors and outcome in critically ill patients with Candida albicans and non-albicans candidaemia.

Methods: A prospective observational study was performed in a medical-surgical ICU at a tertiary academic hospital in Athens, Greece. Non-immunosuppressed, non-neutropenic patients with candidaemia diagnosed after ICU admission were included in the study.

Results: During the study period (01/2001–12/2005) 56 candidaemia episodes among 1,037 ICU admissions were included (5.4%). Among these patients 36/56 (64.3%) had candidaemia due to C. albicans and 20/56 (35.7%) due to non-albicans species [8/56 (14.3%) C. glabrata, 6/56 (10.7%) C. tropicalis, 3/56 (5.4%) C. parapsilosis, 1/56 (1.8%) C. lusitaniae, 1/56 (1.8%) C. krusei and 1/56 (1.8%) C. dubliniensis]. Administration of glucocorticosteroids, central venous catheter (CVC) placement and preexisted candiduria were shown to be independently associated with candidaemia due to C. non-albicans species (OR 45.1, 95% CI 3.0–669.9; OR 26.2, 95% CI 2.1–334.8; and OR 16.5, 95% CI 1.6–173.9, respectively). Mortality was higher in patients with non-albicans spp. than C. albicans blood stream infection [18/20 (90%) vs 19/36 (52.8%), p = 0.005]. The multivariable logistic regression analysis revealed that candidaemia due to non-albicans species was independently associated with death (OR 6.7, 95% CI 1.2–37.7).

Conclusions: In the subset of critically ill non-immunosupressed patients, candidaemia caused by non-albicans species occurred more likely in those with medical devices or receiving steroids. Candidaemia blood stream infection due to non-albicans species was also associated with higher mortality.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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