Candidemia and candiduria in critically ill patients admitted to intensive care units in France: incidence, molecular diversity, management and outcome
| Autor: | Marie-Elisabeth, Bougnoux, Guillaume, Kac, Philippe, Aegerter, Christophe, d'Enfert, Jean-Yves, Fagon, J L, Poirot |
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| Přispěvatelé: | Biologie et Pathogénicité fongiques, Institut Pasteur [Paris]-Institut National de la Recherche Agronomique (INRA), Service de bactériologie, virologie, parasitologie et hygiène, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Biologie et Pathogénicité fongiques (BPF), Institut National de la Recherche Agronomique (INRA)-Institut Pasteur [Paris] (IP), Service de bactériologie, virologie, parasitologie et hygiène [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Université Paris Descartes - Paris 5 (UPD5), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital Ambroise Paré [AP-HP], CandiRea Study Group Members : C. Amrein, F. Bellenfant, A. Novara, V. Lavarde (Hôpital Européen-Georges Pompidou, Paris), M. Auburtin, C. Paugam-Burtz, C. Chochillon (Hôpital Bichat–Claude-Bernard, Paris), M.A Costa de Beauregard, J. Bizet, J.P. Fulgencio (Hôpital Tenon, Paris), S. Boudaoud, C. Lacroix, D. Moreau (Hôpital Saint-Louis, Paris), C. Cerf, S. Bretagne (Hôpital Henri-Mondor, Créteil), M.F. Mamzer, S. Challier (Hôpital Necker, Paris), J. Charpentier, F. Lebreton, H. Yéra (Hôpital Cochin Port-Royal, Paris), B. Clair, G. Loubert, E. Ronco (Hôpital Raymond-Poincaré, Garches), M. Cornet, A. Rabbat (Hôpital Hôtel-Dieu, Paris), A. Datry, V. Leblond (Hôpital Pitié–Salpêtrière, Paris), A.S. Dumenil, D. Ingrand, F. Jacobs (Hôpital Antoine-Béclère, Clamart), J.M. Guérin, J. Mateo, J. Riahi (Hôpital Lariboisière, Paris), P. Guesnon, B. Page (Hôpital Ambroise-Paré, Boulogne), E. Mory, J.M. Ollivier, J.L. Poirot (Hôpital Saint-Antoine, Paris). |
| Rok vydání: | 2007 |
| Předmět: |
Male
Pediatrics MESH: Chi-Square Distribution Antifungal Agents [SDV]Life Sciences [q-bio] Critical Care and Intensive Care Medicine law.invention 0302 clinical medicine MESH: Risk Factors law Risk Factors Outcome Assessment Health Care Medicine MESH: APACHE MESH: Incidence 030212 general & internal medicine Prospective Studies NOCOSOMIAL INFECTIONS Fungemia APACHE Candida MESH: Aged MESH: Microbial Sensitivity Tests 0303 health sciences Cross Infection MESH: Middle Aged CANDIDURIA Incidence (epidemiology) Incidence Candidiasis MOLECULAR TYPING Middle Aged Intensive care unit MESH: Candidiasis 3. Good health Intensive Care Units INTENSIVE CARE UNIT MESH: Critical Illness Female France medicine.drug MLST medicine.medical_specialty Critical Illness Microbial Sensitivity Tests Sepsis 03 medical and health sciences MESH: Candida Intensive care Anesthesiology Humans MESH: Outcome Assessment Health Care MULTI-LOCUS SEQUENCE TYPE Mycosis Aged MESH: Humans Chi-Square Distribution 030306 microbiology business.industry MESH: Cross Infection MESH: Antifungal Agents medicine.disease MESH: Male MESH: Prospective Studies MESH: France CANDIDEMIA CRITICALLY ILL PATIENT MESH: Intensive Care Units business MESH: Female Fluconazole |
| Zdroj: | Intensive Care Medicine Intensive Care Medicine, Springer Verlag, 2008, 34 (2), pp.292-299. ⟨10.1007/s00134-007-0865-y⟩ Intensive Care Medicine, 2008, 34 (2), pp.292-299. ⟨10.1007/s00134-007-0865-y⟩ |
| ISSN: | 0342-4642 1432-1238 |
| DOI: | 10.1007/s00134-007-0865-y⟩ |
| Popis: | International audience; OBJECTIVE: To determine the concomitant incidence, molecular diversity, management and outcome of nosocomial candidemia and candiduria in intensive care unit (ICU) patients in France. DESIGN: A 1-year prospective observational study in 24 adult ICUs. PATIENTS: Two hundred and sixty-two patients with nosocomial candidemia and/or candiduria. MEASUREMENTS AND RESULTS: Blood and urine samples were collected when signs of sepsis were present. Antifungal susceptibility of Candida strains was determined; in addition, all blood and 72% of urine C. albicans isolates were analyzed by using multi-locus sequence type (MLST). The mean incidences of candidemia and candiduria were 6.7 and 27.4/1000 admissions, respectively. Eight percent of candiduric patients developed candidemia with the same species. The mean interval between ICU admission and candidemia was 19.0[Symbol: see text]+/-[Symbol: see text]2.9 days, and 17.2[Symbol: see text]+/-[Symbol: see text]1.1 days for candiduria. C. albicans and C. glabrata were isolated in 54.2% and 17% of blood and 66.5% and 21.6% of urine Candida-positive cultures, respectively. Fluconazole was the most frequently prescribed agent. In all candidemic patients, the prescribed curative antifungal agent was active in vitro against the responsible identified strain. Crude ICU mortality was 61.8% for candidemic and 31.3% for candiduric patients. Seventy-five percent of the patients were infected with a unique C. albicans strain; cross-transmission between seven patients was suggested in one hospital. CONCLUSIONS: Candidemia is late-onset ICU-acquired infection associated with high mortality. No difference in susceptibility and genetic background were found between blood and urine strains of Candida species. |
| Databáze: | OpenAIRE |
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