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Epidemiology, risk factors for and outcome of candidaemia among non‐neutropenic patients in a Greek intensive care unit
Author(s) -
Pratikaki Maria,
Platsouka Evangelia,
Sotiropoulou Christina,
Douka Evangelia,
Paramythiotou Elizabeth,
Kaltsas Panagiotis,
Kotanidou Anastasia,
Paniara Olga,
Roussos Charis,
Routsi Christina
Publication year - 2011
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/j.1439-0507.2009.01787.x
Subject(s) - medicine , ards , intensive care unit , epidemiology , risk factor , severity of illness , illness severity , intensive care , intensive care medicine , lung
Summary To determine the epidemiology, risk factors for and outcome of candidaemia in critically ill patients, a matched case–control study was performed in a 25‐bed intensive care unit (ICU) from August 2004 to January 2006. Candidaemia occurred in 33 patients; each patient was matched to four controls according to admission illness severity, diagnostic category and length of ICU stay. Candida non‐ albicans species predominated (67.7%). The presence of acute respiratory distress syndrome (ARDS) was the only independent risk factor for candidaemia development (OR, 2.93; 95% CI 1.09–7.81, P = 0.032). Mortality was 60.6% among patients with candidaemia and 22% among controls ( P < 0.001). The presence of candidaemia (OR, 9.37; 95% CI 3.48–25.26, P < 0.001) and the illness severity on admission (acute physiologic and chronic health evaluation II score, OR, 1.17; 95% CI 1.12–1.24, P < 0.001) were independently associated with mortality. Among candidaemic patients, risk factors for mortality were the severity of organ dysfunction (sequential organ failure assessment score, OR, 1.57; 95% CI 1.00–2.46, P = 0.05) and a low serum albumin level (OR, 0.74; 95% CI 0.59–0.94, P = 0.012) both of them occurred on candidaemia onset. We conclude that in critically ill patients matched for illness severity and length of ICU stay, the only independent risk factor for candidaemia was the presence of ARDS. Mortality was independently associated with acquisition of candidaemia and with the illness severity at candidaemia onset.