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Characterisation of candidemia in patients with recent surgery: A 7‐year experience
Author(s) -
Orsetti Elena,
Brescini Lucia,
Mazzanti Sara,
Trave Francesca,
Morroni Gianluca,
Masucci Annamaria,
Barchiesi Francesco
Publication year - 2019
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/myc.12988
Subject(s) - medicine , septic shock , pneumonia , epidemiology , mortality rate , surgery , sepsis
Summary Candidemia can complicate major surgical procedures. However, literature data are scanty on this topic. In this study, we evaluated the epidemiology, clinical and microbiologic characteristics and outcome of candidemia in adult patients with recent surgery hospitalised in a single University Hospital in Central Italy from 2010 to 2016. Of the 304 episodes of candidemia, 160 (53%) occurred in surgical patients ( SP s) while the remaining 144 (47%) in patients without history of recent surgery (non‐ SP s). Although either underlying chronic comorbidities (ie haematological malignancies, neurological and gastrointestinal diseases) or acute complications (ie pneumonia and septic shock) were less likely to occur in SP s than in non‐ SP s, 30‐day mortality did not differ between groups being 38% and 42%, respectively. The specific risk factors significantly more common in SP s who died within 30 days were as follows: male gender, older age, being hospitalised in ICU rather than in other wards, having a higher Charlson's score, undergoing previous invasive procedures, haemodialysis, the presence of pneumonia, septic shock, acute kidney failure and the type of surgery. In particular, either gastrointestinal or cardiovascular surgeries were characterised by the highest mortality rates. Multivariate analysis showed that the occurrence of septic shock ( HR 10.3131 [ CI 95% 1.176‐90.466; P = .035] and ICU stay ( HR 2.016 [ CI 95% 1.178‐3.448; P = .011] was independently associated with higher mortality in SP s. Overall, these data show that candidemia in SP s is characterised by significant mortality and distinctive features.