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Risk factors associated to mortality in intensive care unit patients with candidaemia

Abstract number: P1789

Cortizo-Vidal S., Santiago I., Villamil-Cajoto I., Rodriguez-Otero L., Varón C., Aguilera-Guirao A., García-Riestra C., García-Zaabarte Á.

Introduction: After technological and scientific advances during the last three decades, invasive fungal infections turned to emerging infections associated to important morbidity and mortality rates. Medical and surgical ICUs have become the epicentre of candidaemia.

Objectives: Identify main risk factors associated to mortality in intensive care unit (ICU) patients with candidaemia in the Complejo Hospitalario Universitario de Santiago de Compostela in Galicia, Spain.

Methods: We carried out a retrospective study of candidaemia episodes collected at the Complejo Hospitalario Universitario de Santiago de Compostela Microbiology Laboratory from January 2000 to December 2005. We selected the candidaemia isolations from the medical and surgical critical care units. The association study between qualitative variables has been carried out by means of the chi-square test and the Fisher exact test. In order to identify predictive variables for mortality, univariate and multivariate logistic regression models have been adjusted. The following independent variables were analysed: sex, abdominal surgery in the last three months, parenteral nutrition, antifungal treatment, antibiotic treatment, inmunosupresor treatment, catheterisation, mechanical ventilation, Candida albicans fungaemia and being more than 65 years old.

Results: During the study, 77 episodes of ICU-acquired candidaemia were identified. Mortality rate was 50%, but it was higher in patients with Candida albicans fungaemia (odds ratio [OR], 3.1; confidence interval of 95% [CI], 1.2 to 7.9; P < 0.05), in patients older than 65 years ([OR], 4.4; 95% [CI], 1.6 to 11.7; P < 0.05) and in women ([OR], 2.9; 95% [CI], 1.1 to 7.6; P < 0.05). On the contrary, no significant associations between mortality and the rest of the analysed variables were observed.

Conclusion: Candidaemia was associated with a high mortality rate in our ICU. The main risk factors associated with mortality were Candida albicans fungaemia, advanced age and female sex.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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