Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study.

Autor:	Bassetti M; Clinica Malattie Infettive. Ospedale Policlinico San Martino - IRCCS, L.go R. Benzi 10, 16132, Genoa, Italy.; Department of Health Sciences, University of Genoa, Genoa, Italy., Vena A; Clinica Malattie Infettive. Ospedale Policlinico San Martino - IRCCS, L.go R. Benzi 10, 16132, Genoa, Italy. anton.vena@gmail.com.; Department of Health Sciences, University of Genoa, Genoa, Italy. anton.vena@gmail.com., Giacobbe DR; Clinica Malattie Infettive. Ospedale Policlinico San Martino - IRCCS, L.go R. Benzi 10, 16132, Genoa, Italy.; Department of Health Sciences, University of Genoa, Genoa, Italy., Trucchi C; A.Li.Sa. Liguria Health Authority, Genoa, Italy.; Healthcare Planning Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy., Ansaldi F; A.Li.Sa. Liguria Health Authority, Genoa, Italy.; Healthcare Planning Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy., Antonelli M; Department of Intensive Care Anesthesiology and Emercency Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.; Istituto di Anestesiologia e Rianimazione, Università Cattolica del Sacro Cuore, Milan, Italy., Adamkova V; Clinical Microbiology and ATB Centre, Institute of Medical Biochemistry and Laboratory Diagnostics, General University Hospital, Prague, Czech Republic.; Department of Medical Microbiology, Medical Faculty of Palackeho University, Olomouc, Czech Republic., Alicino C; Medical Direction, Santa Corona Hospital, ASL 2 Regional Health System of Liguria, Pietra Ligure, Italy., Almyroudi MP; Attikon General University Hospital, Athens, Greece., Atchade E; Département d'Anesthésie-Réanimation, CHU Bichat-Claude Bernard, HUPNVS, APHP, Paris, France., Azzini AM; Department of Diagnostics and Public Health, Infectious Disease Unit, University of Verona, Verona, Italy., Brugnaro P; Ospedale Civile SS. Giovanni e Paolo, Venice, Italy., Carannante N; First Division of Infectious Diseases, Cotugno Hospital, AORN dei Colli, Naples, Italy., Peghin M; Infectious Diseases Clinic, Santa Maria della Misericordia University Hospital of Udine, ASUFC, Udine, Italy., Berruti M; Clinica Malattie Infettive. Ospedale Policlinico San Martino - IRCCS, L.go R. Benzi 10, 16132, Genoa, Italy.; Department of Health Sciences, University of Genoa, Genoa, Italy., Carnelutti A; Infectious Diseases Clinic, Santa Maria della Misericordia University Hospital of Udine, ASUFC, Udine, Italy., Castaldo N; Infectious Diseases Clinic, Santa Maria della Misericordia University Hospital of Udine, ASUFC, Udine, Italy., Corcione S; Department of Medical Sciences, Infectious Diseases, University of Turin, Turin, Italy., Cortegiani A; Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Palermo, Italy.; Department of Anesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy., Dimopoulos G; Department of Critical Care, University Hospital Attikon, Attikon Medical School, Νational and Kapodistrian University of Athens, Athens, Greece., Dubler S; Department of Anesthesiology and Intensive Care Medicine, Heidelberg University Hospital, Heidelberg, Germany., García-Garmendia JL; Servicio de Cuidados Críticos y Urgencias, Hospital San Juan de Dios del Aljarafe, Bormujos, Seville, Spain., Girardis M; Department of Anesthesia and Intensive Care, University Hospital of Modena, Modena, Italy., Cornely OA; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.; University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.; University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany.; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany., Ianniruberto S; Infectious Diseases Unit, Department of Medical and Surgical Science, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy., Kullberg BJ; Radboud Umc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands., Lagrou K; Department of Laboratory Medicine and National Reference Centre for Mycosis, University Hospitals of Leuven, Leuven, Belgium.; Department of Microbiology and Immunology and Transplantation, KU Leuven, Leuven, Belgium., Lebihan C; APHP; Medical and Infectious Diseases ICU (MI2), Bichat Hospital, 75018, Paris, France., Luzzati R; Infectious Diseases Department, Azienda Sanitaria Universitaria Integrata Di Trieste, Trieste, Italy., Malbrain M; Department of Intensive Care Medicine, University Hospital Brussels (UZB), 1090, Jette, Belgium.; Faculty of Medicine and Pharmacy, Vrije Unversiteit Brussel (VUB), 1090, Brussels, Belgium., Merelli M; Infectious Diseases Clinic, Santa Maria della Misericordia University Hospital of Udine, ASUFC, Udine, Italy., Marques AJ; C.H. Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal., Martin-Loeches I; Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St. James's Hospital, Dublin, Ireland.; Centro de Investigación Biomedica En Red-Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.; Pneumology Department, Respiratory Institute, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer - University of Barcelona, Barcelona, Spain., Mesini A; Department of Health Sciences, University of Genoa, Genoa, Italy., Paiva JA; Department of Emergency and Intensive Care Medicine, Centro Hospitalar Universitário São João, Faculdade de Medicina da Universidade Do Porto E Grupo de Infecção E Sépsis, Porto, Portugal., Raineri SM; Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Palermo, Italy.; Institute for Biomedical Research and Innovation (IRIB) - National Research Council (CNR), Palermo, Italy., Rautemaa-Richardson R; Faculty of Biology, Medicine and Health, Division of Evolution, Infection and Genomics, University of Manchester, Manchester, UK.; Department of Infectious Diseases, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK., Schouten J; Radboud Umc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands., Spapen H; Universitair Ziekenhuis Brussel, VUB University, Brussels, Belgium., Tasioudis P; G. Gennimatas General Hospital of Thessaloniki, Thessaloniki, Greece., Timsit JF; Université Paris Diderot/Hopital Bichat-Réanimation Medicale et Des Maladies Infectieuses, Paris, France.; UMR 1137-IAME Team 5-DeSCID: Decision Sciences in Infectious Diseases, Control and Care, Inserm/Univ Paris Diderot, Sorbonne Paris Cité, Paris, France., Tisa V; Department of Health Sciences, University of Genoa, Genoa, Italy., Tumbarello M; Institute of Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy., Van den Berg CHSB; Department of Intensive Care, University Medical Center Groningen, Groningen, the Netherlands., Veber B; Pole Anesthésie-Réanimation-SAMU, Rouen University Hospital, Rouen, France., Venditti M; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy., Voiriot G; Service de Réanimation Et USC Médico-Chirurgicale, AP-HP, Hôpitaux Universitaires de L'Est Parisien, Pôle TVAR, Hôpital Tenon, Paris, France., Wauters J; Department of General Internal Medicine, Medical Intensive Care Unit, University Hospitals Leuven, Leuven, UK., Zappella N; Centre Hospitalier de Versailles, Versailles, France., Montravers P; Université de Paris, INSERM UMR 1152 - PHERE, Paris, France.
Jazyk:	angličtina
Zdroj:	Infectious diseases and therapy [Infect Dis Ther] 2022 Apr; Vol. 11 (2), pp. 827-840. Date of Electronic Publication: 2022 Feb 19.
DOI:	10.1007/s40121-021-00585-6
Abstrakt:	Introduction: Intra-abdominal infections represent the second most frequently acquired infection in the intensive care unit (ICU), with mortality rates ranging from 20% to 50%. Candida spp. may be responsible for up to 10-30% of cases. This study assesses risk factors for development of intra-abdominal candidiasis (IAC) among patients admitted to ICU. Methods: We performed a case-control study in 26 European ICUs during the period January 2015-December 2016. Patients at least 18 years old who developed an episode of microbiologically documented IAC during their stay in the ICU (at least 48 h after admission) served as the case cohort. The control group consisted of adult patients who did not develop episodes of IAC during ICU admission. Matching was performed at a ratio of 1:1 according to time at risk (i.e. controls had to have at least the same length of ICU stay as their matched cases prior to IAC onset), ICU ward and period of study. Results: During the study period, 101 case patients with a diagnosis of IAC were included in the study. On univariate analysis, severe hepatic failure, prior receipt of antibiotics, prior receipt of parenteral nutrition, abdominal drain, prior bacterial infection, anastomotic leakage, recurrent gastrointestinal perforation, prior receipt of antifungal drugs and higher median number of abdominal surgical interventions were associated with IAC development. On multivariate analysis, recurrent gastrointestinal perforation (OR 13.90; 95% CI 2.65-72.82, p = 0.002), anastomotic leakage (OR 6.61; 95% CI 1.98-21.99, p = 0.002), abdominal drain (OR 6.58; 95% CI 1.73-25.06, p = 0.006), prior receipt of antifungal drugs (OR 4.26; 95% CI 1.04-17.46, p = 0.04) or antibiotics (OR 3.78; 95% CI 1.32-10.52, p = 0.01) were independently associated with IAC. Conclusions: Gastrointestinal perforation, anastomotic leakage, abdominal drain and prior receipt of antifungals or antibiotics may help to identify critically ill patients with higher probability of developing IAC. Prospective studies are needed to identify which patients will benefit from early antifungal treatment. (© 2022. The Author(s).)
Databáze:	MEDLINE
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