Candidemia is a well-recognized complication of hospital stay, especially in critically ill patients. There is not a general consensus that predictors for candidemia in cardiosurgical intensive care unit (cICU) are different from a general ICU and it has been reported that cardiopulmonary bypass time is a specific risk factor in the cICU. We performed a prospective study to evaluate the main predictors for candidemia in patients admitted to the cICU. Included patients were adults admitted between July 2005 and December 2007 with an ICU-length of stay (ICU-LOS) ≥48 hours after cardiac surgery. Exclusion criteria were solid organ or bone marrow transplants, previous diagnosis of candidemia or other invasive infections and ICU stay before surgery. A multiple regression analysis was performed to identify the risk factors. Among 1955 patients admitted to the cICU, 345 were enrolled. Only 26 patients (1.3%) had candidemia after an ICU-LOS of 20 days (inter-quartile range, IQR 8-49 days). Total parenteral nutrition [odds ratio (OR) = 9.56; confidence interval (CI) = 1.741-52.534], severe sepsis (OR = 4.20; CI = 1.292-13.667), simplified acute physiology score II (OR = 1.16; CI = 1.052-1.278) and ICU-LOS >20 days (OR=6.38; CI = 1.971-20.660) were independent predictors of candidemia. Patients undergoing cardiac surgery developed candidemia late after cICU admission and the independent predictors were similar to the general ICU. © 2011 Published by European Association for Cardio-Thoracic Surgery.
Candidemia after cardiac surgery in the intensive care unit: An observational study / Pasero, D.; de Rosa, F. G.; Rana, N. K.; Fossati, L.; Davi, A.; Rinaldi, M.; Di Perri, G.; Ranieri, V. M.. - In: INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY. - ISSN 1569-9293. - 12:3(2011), pp. 374-378. [10.1510/icvts.2010.257931]
Candidemia after cardiac surgery in the intensive care unit: An observational study
Pasero D.
;
2011-01-01
Abstract
Candidemia is a well-recognized complication of hospital stay, especially in critically ill patients. There is not a general consensus that predictors for candidemia in cardiosurgical intensive care unit (cICU) are different from a general ICU and it has been reported that cardiopulmonary bypass time is a specific risk factor in the cICU. We performed a prospective study to evaluate the main predictors for candidemia in patients admitted to the cICU. Included patients were adults admitted between July 2005 and December 2007 with an ICU-length of stay (ICU-LOS) ≥48 hours after cardiac surgery. Exclusion criteria were solid organ or bone marrow transplants, previous diagnosis of candidemia or other invasive infections and ICU stay before surgery. A multiple regression analysis was performed to identify the risk factors. Among 1955 patients admitted to the cICU, 345 were enrolled. Only 26 patients (1.3%) had candidemia after an ICU-LOS of 20 days (inter-quartile range, IQR 8-49 days). Total parenteral nutrition [odds ratio (OR) = 9.56; confidence interval (CI) = 1.741-52.534], severe sepsis (OR = 4.20; CI = 1.292-13.667), simplified acute physiology score II (OR = 1.16; CI = 1.052-1.278) and ICU-LOS >20 days (OR=6.38; CI = 1.971-20.660) were independent predictors of candidemia. Patients undergoing cardiac surgery developed candidemia late after cICU admission and the independent predictors were similar to the general ICU. © 2011 Published by European Association for Cardio-Thoracic Surgery.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.