Incidence, risk factors, and predictors of outcome of candidemia. Survey in 2 Italian university hospitals
Incidence, risk factors, and predictors of outcome of candidemia. Survey in 2 Italian university hospitals
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DOI：
10.1016/j.diagmicrobio.2007.01.005
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发表时间：
2007-07-01
影响因子：
2.9
通讯作者：
Tumbarello, Mario
中科院分区：
文献类型：
--
作者：
Bassetti, Matteo;Trecarichi, Enrico Maria;Tumbarello, Mario
近几十年来，念珠菌成为院内血流感染的第四大常见原因。念珠菌的发病率为0。每100人中有13人。念珠菌感染83例（61%）由白色念珠菌引起，53例（39%）由非白色念珠菌引起。念珠菌对氟康唑耐药12株（9%），对伊曲康唑耐药5株（4%），对伏立康唑耐药2株（1.5%），对5-氟胞嘧啶耐药12株（9%），对两性霉素b耐药1株（0.7%）。肠外营养和慢性肾功能衰竭是与念珠菌的发展独立相关的变量。预后指标多因素logistic回归分析显示，与预后不良相关的自变量为初始治疗不充分（P < 0.001）和APACHEⅲ评分高（P = 0.004）。与死亡率相关的初始治疗不充分表明需要进行额外的调查，以确定高危患者，以便进行有益的抗真菌预防。(c) 2007爱思唯尔公司版权所有。
In recent decades, Candida spp. emerged as the fourth most common cause of nosocomial bloodstream infections. The incidence of candidemia was 0. 13 per 100 persons. Eighty-three cases (61 %) of candidemia were due to Candida albicans and 53 (39 %) to nonalbicans Candida spp. Twelve strains of Candida (9 %) had shown in vitro resistance to fluconazole, 5 (4 %) to itraconazole, 2 (1.5 %) to voriconazole, 12 (9 %) to 5-flucytosine, and 1 (0.7%) to amphotericin B. Multivariate logistic regression analysis of risk factors showed that length of hospitalization, presence of a central venous catheter, previous episodes of candidemia or bacteremia, parenteral nutrition, and chronic renal failure were variables independently associated with the development of candidemia. Multivariate logistic regression analysis of prognostic indicators showed that the independent variables associated with poor prognosis were inadequate initial therapy (P < .001) and high APACHE III score (P = .004). The inadequate initial therapy associated with mortality indicates the need for additional investigations to define high-risk patients for beneficial antifungal prophylaxis. (c) 2007 Elsevier Inc. All rights reserved.