Mortality-associated factors of candidemia: a multi-center prospective cohort in Turkey.

Autor: Kutlu M; Infectious Diseases and Clinical Microbiology, Pamukkale University, Denizli, Turkey. muratkutlu72@yahoo.com.; Infectious Diseases and Clinical Microbiology Department, Pamukkale University, School of Medicine, Kınıklı/Pamukkale, 20070, Denizli, Turkey. muratkutlu72@yahoo.com., Sayın-Kutlu S; Infectious Diseases and Clinical Microbiology, Pamukkale University, Denizli, Turkey., Alp-Çavuş S; Infectious Diseases and Clinical Microbiology, Dokuz Eylul University, İzmir, Turkey., Öztürk ŞB; Infectious Diseases and Clinical Microbiology, Adnan Menderes University, Aydın, Turkey., Taşbakan M; Infectious Diseases and Clinical Microbiology, Ege University, İzmir, Turkey., Özhak B; Medical Microbiology, Akdeniz University, Antalya, Turkey., Kaya O; Infectious Diseases and Clinical Microbiology, Süleyman Demirel University, Isparta, Turkey., Kutsoylu OE; Infectious Diseases and Clinical Microbiology, Dokuz Eylul University, İzmir, Turkey., Şenol-Akar Ş; Infectious Diseases and Clinical Microbiology, Celal Bayar University, Manisa, Turkey., Turhan Ö; Infectious Diseases and Clinical Microbiology, Akdeniz University, Antalya, Turkey., Mermut G; Infectious Diseases and Clinical Microbiology, Ege University, İzmir, Turkey., Ertuğrul B; Infectious Diseases and Clinical Microbiology, Adnan Menderes University, Aydın, Turkey., Pullukcu H; Infectious Diseases and Clinical Microbiology, Ege University, İzmir, Turkey., Çetin ÇB; Infectious Diseases and Clinical Microbiology, Celal Bayar University, Manisa, Turkey., Avkan-Oğuz V; Infectious Diseases and Clinical Microbiology, Dokuz Eylul University, İzmir, Turkey., Yapar N; Infectious Diseases and Clinical Microbiology, Dokuz Eylul University, İzmir, Turkey., Yeşim-Metin D; Medical Microbiology, Ege University, İzmir, Turkey., Ergin Ç; Medical Microbiology, Pamukkale University, Denizli, Turkey.
Jazyk: angličtina
Zdroj: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology [Eur J Clin Microbiol Infect Dis] 2022 Apr; Vol. 41 (4), pp. 597-607. Date of Electronic Publication: 2022 Jan 27.
DOI: 10.1007/s10096-021-04394-0
Abstrakt: Candidemia may present as severe and life-threatening infections and is associated with a high mortality rate. This study aimed to evaluate the risk factors associated with 30-day mortality in patients with candidemia. A multi-center prospective observational study was conducted in seven university hospitals in six provinces in the western part of Turkey. Patient data were collected with a structured form between January 2018 and April 2019. In total, 425 episodes of candidemia were observed during the study period. Two hundred forty-one patients died within 30 days, and the 30-day crude mortality rate was 56.7%. Multivariable analysis found that SOFA score (OR: 1.28, CI: 1.154-1.420, p < 0.001), parenteral nutrition (OR: 3.9, CI: 1.752-8.810, p = 0.001), previous antibacterial treatment (OR: 9.32, CI: 1.634-53.744, p = 0.012), newly developed renal failure after candidemia (OR: 2.7, CI: 1.079-6.761, p = 0.034), and newly developed thrombocytopenia after candidemia (OR: 2.6, CI: 1. 057-6.439, p = 0.038) were significantly associated with 30-day mortality. Central venous catheter removal was the only factor protective against mortality (OR: 0.34, CI:0.147-0.768, p = 0.010) in multivariable analysis. Candidemia mortality is high in patients with high SOFA scores, those receiving TPN therapy, and those who previously received antibacterial therapy. Renal failure and thrombocytopenia developing after candidemia should be followed carefully in patients. Antifungal therapy and removing the central venous catheter are essential in the management of candidemia.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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