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An Ex vivo Assay to Study Candida albicans Hyphal Morphogenesis in the Gastrointestinal Tract
Published on: July 1, 2020
Candidaemia in internal medicine departments: the burden of a rising problem
M Bassetti1, M P Molinari, M Mussap
1Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy. mattba@tin.it
Abstract:
Although internal medicine wards (IMWs) represent a significant reservoir of patients with candidemia, few investigators have specifically addressed the epidemiological aspects of candidaemia in this population. Of all patients hospitalized during the study period with candidaemia, 133/348 (38%) were admitted to IMWs. Variables associated with IMWs included: antibiotic therapy prior to hospitalization, urinary or central venous catheter, parenteral nutrition, tumour and age >75 years. Overall, 30-day mortality in IMWs was significantly higher than that in other wards (51.1% vs. 38.2%, p <0.02). Multiple logistic regression analysis identified the administration of antifungal treatment 48 h after having the first positive BC as an independent determinant of hospital mortality. Patients with candidaemia in IMWs account for a substantial proportion of patients with candidaemia and have higher mortality compared with patients in other wards.
Insights
Patients with candidemia admitted to internal medicine wards (IMWs) face higher mortality rates. Delayed antifungal treatment significantly increases hospital death risk for these patients.
Area of Science:
- Infectious Diseases
- Epidemiology
- Internal Medicine
Background:
- Internal medicine wards (IMWs) are a significant source of patients with candidemia.
- Limited research exists on the specific epidemiology of candidemia within IMWs.
Purpose of the Study:
- To investigate the epidemiological characteristics of candidemia in patients admitted to IMWs.
- To identify risk factors and outcomes associated with candidemia in this patient population.
Main Methods:
- Retrospective analysis of hospitalized patients with candidemia.
- Comparison of patient demographics, risk factors, and outcomes between IMWs and other hospital wards.
- Logistic regression analysis to determine independent predictors of mortality.
Main Results:
- 38% of all candidemia patients were admitted to IMWs.
- Factors associated with IMW admission included prior antibiotic use, catheters, parenteral nutrition, tumors, and age >75.
- 30-day mortality was significantly higher in IMWs (51.1%) compared to other wards (38.2%).
- Delayed antifungal treatment (after 48 hours from positive blood culture) was an independent predictor of mortality.
Conclusions:
- Candidemia patients in IMWs represent a substantial group with poorer outcomes.
- Higher mortality in IMWs is linked to patient factors and potentially delayed treatment.
- Timely antifungal administration is crucial for improving survival in candidemia patients.
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