Yıl 2021, Cilt 5 , Sayı 1, Sayfalar 97 - 102 2021-01-01

Changing epidemiology and risk factors for candidemia in critically ill patients

Zuhal YEŞİLBAĞ [1] , Yasemin TEKDÖŞ ŞEKER [2] , Kübra AVCI [3] , Sevtap ŞENOĞLU [4] , Zafer ÇUKUROVA [5] , Gülsüm Oya HERGÜNSEL [6]


Background/Aim: Candidemia is a common cause of bloodstream infections in critically ill patients, resulting in high mortality and morbidity. This retrospective case-control study was designed to identify epidemiological characteristics and risk factors for candidemia in an intensive care unit. Methods: A total of 166 patients hospitalized in the intensive care unit between January 2013 and December 2017 were included in this case-control study. Candidemia was defined as at least one positive blood culture for Candida spp. with fever or other clinical findings consistent with infection. Patients who acquired candidemia more than 48 hours after admission represented the case group (n=83). Control group (n=83) consisted of case-matching patients who were hospitalized during the same period and did not develop candidemia. Results: In the candidemia group Candida albicans (57.8%) was the most common species, followed by Candida glabrata (13.3%) and Candida parapsilosis (12%). The rate of C. albicans decreased from 69.2% to 50% during the five-year study period. Out of 83 candidemia infections, 36 (43.4%) were associated with central venous catheters. C. parapsilosis had an increasing rate in parallel with central venous catheter-associated candidemia rates. When comparing cases and controls, in univariate analysis, Sequential Organ Failure Assessment (SOFA) score, blood transfusion, central venous catheter placement, intubation, gastrointestinal surgery and total parenteral nutrition were significantly more common in the candidemia group (P<0.05 for each). The rate of the patients whose Candida scores were higher or equal to 3, was significantly higher in candidemia group (P=0.03). According to the multivariate analysis, SOFA scores (P<0.001, OR:1.25, 95% CI:1.15-1.37), gastrointestinal surgery (P=0.03, OR:2.60, 95% CI:1.10-6.12), central venous catheter (P=0.04, OR:2.62, 95% CI:1.05-6.57) and total parenteral nutrition (P=0.02, OR:2.61, 95% CI:1.12-6.06) were independent risk factors for candidemia, while enteral feeding (P=0.02, OR:0.27, 95% CI:0.09-0.80) was protective against. Conclusion: The result of our study is an evidence of the changing epidemiology of candidemia, which showed a shift towards non-albicans Candida spp. over the years. The increasing rate of C. parapsilosis and central venous catheter-associated candidemia has highlighted the need for more attention to the central line care and hand hygiene. Our study also revealed that critically ill patients with high SOFA score, gastrointestinal surgery, central venous catheter, and total parenteral nutrition have an elevated risk for developing candidemia. Unless necessary, limitation of total parenteral nutrition, and ensuring the earlier implementation of enteral feeding may be protective from candidemia.
Candidemia, epidemiology, intensive care unit, risk factors
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Birincil Dil en
Konular Enfeksiyon Hastalıkları, Yoğun Bakım, Tıp
Bölüm Araştırma makalesi
Yazarlar

Orcid: 0000-0002-7210-1084
Yazar: Zuhal YEŞİLBAĞ (Sorumlu Yazar)
Kurum: UNIVERSITY OF HEALTH SCIENCES, ISTANBUL BAKIRKOY DR. SADI TRAINING AND RESEARCH CENTER, DEPARTMENT OF INFECTIOUS DISEASES AND CLINICAL MICROBIOLOGY
Ülke: Turkey


Orcid: 0000-0001-6924-9814
Yazar: Yasemin TEKDÖŞ ŞEKER
Kurum: UNIVERSITY OF HEALTH SCIENCES, İSTANBUL BAKIRKÖY DR. SADİ KONUK TRAINING RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF ANESTHESIOLOGY
Ülke: Turkey


Orcid: 0000-0003-2225-7272
Yazar: Kübra AVCI
Kurum: UNIVERSITY OF HEALTH SCIENCES, ISTANBUL BAKIRKOY DR. SADI TRAINING AND RESEARCH CENTER, DEPARTMENT OF INFECTIOUS DISEASES AND CLINICAL MICROBIOLOGY
Ülke: Turkey


Orcid: 0000-0003-4796-9583
Yazar: Sevtap ŞENOĞLU
Kurum: UNIVERSITY OF HEALTH SCIENCES, ISTANBUL BAKIRKOY DR. SADI TRAINING AND RESEARCH CENTER, DEPARTMENT OF INFECTIOUS DISEASES AND CLINICAL MICROBIOLOGY
Ülke: Turkey


Orcid: 0000-0002-8893-3977
Yazar: Zafer ÇUKUROVA
Kurum: UNIVERSITY OF HEALTH SCIENCES, İSTANBUL BAKIRKÖY DR. SADİ KONUK TRAINING RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF ANESTHESIOLOGY
Ülke: Turkey


Orcid: 0000-0003-3218-0029
Yazar: Gülsüm Oya HERGÜNSEL
Kurum: UNIVERSITY OF HEALTH SCIENCES, İSTANBUL BAKIRKÖY DR. SADİ KONUK TRAINING RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF ANESTHESIOLOGY
Ülke: Turkey


Tarihler

Yayımlanma Tarihi : 1 Ocak 2021

Bibtex @araştırma makalesi { josam871514, journal = {Journal of Surgery and Medicine}, issn = {}, eissn = {2602-2079}, address = {jsurgmed@gmail.com}, publisher = {Fatih BAŞAK}, year = {2021}, volume = {5}, pages = {97 - 102}, doi = {10.28982/josam.871514}, title = {Changing epidemiology and risk factors for candidemia in critically ill patients}, key = {cite}, author = {Yeşilbağ, Zuhal and Tekdöş Şeker, Yasemin and Avcı, Kübra and Şenoğlu, Sevtap and Çukurova, Zafer and Hergünsel, Gülsüm Oya} }
APA Yeşilbağ, Z , Tekdöş Şeker, Y , Avcı, K , Şenoğlu, S , Çukurova, Z , Hergünsel, G . (2021). Changing epidemiology and risk factors for candidemia in critically ill patients . Journal of Surgery and Medicine , 5 (1) , 97-102 . DOI: 10.28982/josam.871514
MLA Yeşilbağ, Z , Tekdöş Şeker, Y , Avcı, K , Şenoğlu, S , Çukurova, Z , Hergünsel, G . "Changing epidemiology and risk factors for candidemia in critically ill patients" . Journal of Surgery and Medicine 5 (2021 ): 97-102 <http://jsurgmed.com/tr/pub/issue/59430/871514>
Chicago Yeşilbağ, Z , Tekdöş Şeker, Y , Avcı, K , Şenoğlu, S , Çukurova, Z , Hergünsel, G . "Changing epidemiology and risk factors for candidemia in critically ill patients". Journal of Surgery and Medicine 5 (2021 ): 97-102
RIS TY - JOUR T1 - Changing epidemiology and risk factors for candidemia in critically ill patients AU - Zuhal Yeşilbağ , Yasemin Tekdöş Şeker , Kübra Avcı , Sevtap Şenoğlu , Zafer Çukurova , Gülsüm Oya Hergünsel Y1 - 2021 PY - 2021 N1 - doi: 10.28982/josam.871514 DO - 10.28982/josam.871514 T2 - Journal of Surgery and Medicine JF - Journal JO - JOR SP - 97 EP - 102 VL - 5 IS - 1 SN - -2602-2079 M3 - doi: 10.28982/josam.871514 UR - https://doi.org/10.28982/josam.871514 Y2 - 2021 ER -
EndNote %0 Journal of Surgery and Medicine Changing epidemiology and risk factors for candidemia in critically ill patients %A Zuhal Yeşilbağ , Yasemin Tekdöş Şeker , Kübra Avcı , Sevtap Şenoğlu , Zafer Çukurova , Gülsüm Oya Hergünsel %T Changing epidemiology and risk factors for candidemia in critically ill patients %D 2021 %J Journal of Surgery and Medicine %P -2602-2079 %V 5 %N 1 %R doi: 10.28982/josam.871514 %U 10.28982/josam.871514
ISNAD Yeşilbağ, Zuhal , Tekdöş Şeker, Yasemin , Avcı, Kübra , Şenoğlu, Sevtap , Çukurova, Zafer , Hergünsel, Gülsüm Oya . "Changing epidemiology and risk factors for candidemia in critically ill patients". Journal of Surgery and Medicine 5 / 1 (Ocak 2021): 97-102 . https://doi.org/10.28982/josam.871514
AMA Yeşilbağ Z , Tekdöş Şeker Y , Avcı K , Şenoğlu S , Çukurova Z , Hergünsel G . Changing epidemiology and risk factors for candidemia in critically ill patients. J Surg Med. 2021; 5(1): 97-102.
Vancouver Yeşilbağ Z , Tekdöş Şeker Y , Avcı K , Şenoğlu S , Çukurova Z , Hergünsel G . Changing epidemiology and risk factors for candidemia in critically ill patients. Journal of Surgery and Medicine. 2021; 5(1): 97-102.
IEEE Z. Yeşilbağ , Y. Tekdöş Şeker , K. Avcı , S. Şenoğlu , Z. Çukurova ve G. Hergünsel , "Changing epidemiology and risk factors for candidemia in critically ill patients", Journal of Surgery and Medicine, c. 5, sayı. 1, ss. 97-102, Oca. 2021, doi:10.28982/josam.871514