Evaluation of Epidemiological Characteristics and Risk Factors of Candidemia in Adult Patients in a Tertiary-Care Hospital

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dc.contributor.authorKocak, Bahar Yenigun
dc.contributor.authorKuloglu, Figen
dc.contributor.authorCelik, Aygul Dogan
dc.contributor.authorAkata, Filiz
dc.date.accessioned2024-06-12T10:55:36Z
dc.date.available2024-06-12T10:55:36Z
dc.date.issued2011
dc.departmentTrakya Üniversitesien_US
dc.description.abstractCandida species which are currently the fourth most common cause of nosocomial bloodstream infections, are associated with a significant morbidity and mortality. The aim of this retrospective case-control study which included adult patients was to determine the epidemiology of candidemia and to evaluate risk factors for the development of candidemia and mortality at a tertiary-care education hospital over a 1-year period. A total of 38 candidemia cases (23 were male; age range: 17-82 yrs; mean age: 61.4 +/- 13.5 years) were identified among 22.507 patients hospitalized during the study period (January 1-December 31, 2008) and the overall incidence was found as 16.8 per 10.000 hospital admissions. Control group (n= 36; 22 were male; mean age: 60.9 +/- 16.3 years) was selected among patients who had no signs and symptoms of candidemia and had negative blood cultures during the study period. Thirty-six (95%) patients with candidemia were identified as nosocomial infection. The most frequently isolated species were C.albicans (55.2%) and C.parapsilosis (28.9%) and the primarily identified origin of infection was central venous catheter use (39%). Candida spp. isolation was most frequent in patients hospitalized in intensive care units (13/38; 34.2%), followed by surgery (n= 8; 21%) and chest diseases (n= 5; 13). Univariate analysis revealed that presence of a central venous catheter [odds ratio (OR): 4.33; 95% confidence interval (Cl): 1.63-11.47, p= 0.003] and the length of hospitalization (OR: 0.97; CI: 0.94-1.00, p= 0.01) were the most frequently associated factors with an increased risk of candidemia compared to controls. However, multivariate analysis exhibited presence of a central venous catheter (OR: 2.90; CI: 1.04-8.11, p= 0.04) as the only independent risk factor for the development of candidemia. Therapy was initiated with intravenous fluconazole (mean duration of therapy 13.2 +/- 6.25 days) and in three patients following fluconazol use step-up therapy was initiated. Total mortality rate was 58% (22/38) in our case series. Risk factors for mortality due to candidemia in the univariate analysis were detected as no response to antifungal treatment (OR: 0.23; CI: 0.11-0.51, p< 0.001), underlying disease other than trauma (OR: 0.06; CI: 0.003-1.24, p= 0.02), and high Charlson index (OR: 0.60; CI: 0.38-0.93, p= 0.03), however those factors were not found significant by multivariate analysis. There was also a statistically significant correlation between Charlson index and treatment response (mean Charlson index was 3.5 +/- 1.9 in therapy-responded patients and 4.8 +/- 1.8 in non-responders; p= 0.03). Since the risk of developing candidemia was significantly higher in severely diseased patients using central venous catheter or with prolonged hospitalization, response to antifungal therapy may be insufficient, leading to higher mortality.en_US
dc.identifier.endpage503en_US
dc.identifier.issn0374-9096
dc.identifier.issue3en_US
dc.identifier.pmid21935782en_US
dc.identifier.scopus2-s2.0-80052506461en_US
dc.identifier.scopusqualityQ4en_US
dc.identifier.startpage489en_US
dc.identifier.urihttps://hdl.handle.net/20.500.14551/19483
dc.identifier.volume45en_US
dc.identifier.wosWOS:000294879100012en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isotren_US
dc.publisherAnkara Microbiology Socen_US
dc.relation.ispartofMikrobiyoloji Bultenien_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectCandidemiaen_US
dc.subjectEpidemiologyen_US
dc.subjectRisk Factorsen_US
dc.subjectMortalityen_US
dc.subjectPopulation-Based Surveillanceen_US
dc.subjectNosocomial Fungal-Infectionsen_US
dc.subjectClinical-Practice Guidelinesen_US
dc.subjectBlood-Stream Infectionsen_US
dc.subjectIntensive-Careen_US
dc.subjectDiseases Societyen_US
dc.subjectUnited-Statesen_US
dc.subject2009 Updateen_US
dc.subjectPredictorsen_US
dc.subjectCandidiasisen_US
dc.titleEvaluation of Epidemiological Characteristics and Risk Factors of Candidemia in Adult Patients in a Tertiary-Care Hospitalen_US
dc.typeArticleen_US

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