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Candidaemia: incidence, risk factors, characteristics and outcomes in immunocompetent critically ill patients

K Z Vardakas1, A Michalopoulos, K G Kiriakidou

  • 1Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|January 22, 2009
PubMed

Insights

Candida colonization and gastrointestinal surgery are key risk factors for candidaemia (yeast infection in the bloodstream) in intensive care unit (ICU) patients. Treatment failure significantly impacts mortality rates.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Epidemiology

Background:

  • Candidaemia poses a significant threat to critically ill patients.
  • Identifying risk factors is crucial for timely intervention and improved outcomes.
  • Previous studies have highlighted various potential contributors to fungal bloodstream infections.

Purpose of the Study:

  • To identify independent risk factors for the development of candidaemia in intensive care unit (ICU) patients.
  • To determine the association between specific patient characteristics and candidaemia.
  • To analyze mortality rates and treatment outcomes in patients with candidaemia.

Main Methods:

  • A matched case-control study design was employed.
  • Patients were matched based on ICU stay duration, age, admission department, admission year, and sex.
  • Data on candidaemia development, colonization, surgical history, and mortality were collected and analyzed.

Main Results:

  • Candidaemia occurred in 0.6 cases per 1000 patient-days.
  • Independent risk factors for candidaemia included Candida colonization and gastrointestinal surgery.
  • Patients with candidaemia often presented with multiple organ failure and end-stage disease.

Conclusions:

  • Candida colonization and gastrointestinal surgery are significant predictors of candidaemia in ICU settings.
  • High mortality rates (40% ICU, 66.7% in-hospital) are associated with candidaemia.
  • Treatment failure emerged as the sole predictor of in-hospital mortality, underscoring the need for effective therapeutic strategies.

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