Mortality-associated factors of candidemia: a multi-center prospective cohort in Turkey
| Autor: | Murat Kutlu, Selda Sayın-Kutlu, Sema Alp-Çavuş, Şerife Barçın Öztürk, Meltem Taşbakan, Betil Özhak, Onur Kaya, Oya Eren Kutsoylu, Şebnem Şenol-Akar, Özge Turhan, Gülşen Mermut, Bülent Ertuğrul, Hüsnü Pullukcu, Çiğdem Banu Çetin, Vildan Avkan-Oğuz, Nur Yapar, Dilek Yeşim-Metin, Çağrı Ergin |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Fluconazole Therapy
Antifungal Agents Candida parapsilosis Turkey Epidemiology retrospective study thrombocytopenia Critically-Ill Patients Turkey (republic) Intensive-Care-Unit fluconazole Candida albicans antibiotic therapy Central Venous Catheters odds ratio Risk-Factors antibiotic agent antifungal agent Prospective Studies caspofungin Candida crude mortality rate adult prednisolone Species Distribution clinical trial General Medicine cohort analysis amphotericin B itraconazole aged Infectious Diseases echinocandin female risk factor drug substitution drug withdrawal prospective study Microbiology (medical) corticosteroid therapy Blood-Stream Infection parenteral nutrition university hospital anidulafungin Article male turkey (bird) patient coding voriconazole antifungal susceptibility Candida endocarditis neutropenia Sequential Organ Failure Assessment Score Humans controlled study human bacteremia Mortality Device Removal unspecified side effect Retrospective Studies Candida endophthalmitis micafungin amphotericin B lipid complex candidemia microbiology Catheter removal candidiasis major clinical study posaconazole data collection method kidney failure Septic Shock multicenter study Risk factors Antifungal Therapy observational study Invasive Candidiasis |
| Popis: | 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: | OpenAIRE |
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