Risk factors for noncatheter-related Candida bloodstream infections in intensive care units: A multicenter case-control study

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dc.contributor.authorArslan, Feryat
dc.contributor.authorÇaşkurlu, Hülya
dc.contributor.authorSarı, Sema
dc.contributor.authorÇankar Dal, Hayriye
dc.contributor.authorTuran, Sema
dc.contributor.authorErtürk Şengel, Betül
dc.contributor.authorGül, Fethi
dc.contributor.authorYeşilbağ, Zuhal
dc.contributor.authorEren, Gülay
dc.contributor.authorTemel, Şahin
dc.contributor.authorAlp, Emine
dc.contributor.authorGöl Serin, Başak
dc.contributor.authorKöse, Şükran
dc.contributor.authorÇalık, Şebnem
dc.contributor.authorTuncel, Zeki Tekgül
dc.contributor.authorŞenbayrak, Seniha
dc.contributor.authorSarı, Ahmet
dc.contributor.authorKaragöz, Gül
dc.contributor.authorGöksu Tomruk, Senay
dc.contributor.authorŞen, Betül
dc.contributor.authorHızarcı, Burcu
dc.contributor.authorVahaboğlu, Haluk
dc.date.accessioned2019-12-30T09:36:21Z
dc.date.available2019-12-30T09:36:21Z
dc.date.issued2019
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Anesteziyoloji ve Reanimasyon Ana Bilim Dalı
dc.description.abstractCandida bloodstream infections are associated with high mortality among critically ill patients in intensive care units (ICUs). Studies that explore the risk factors for candidemia may support better patient care in intensive care units. We conducted a retrospective, multicenter case-control study to investigate the risk factors for noncatheter-related Candida bloodstream infections (CBSI) in adult ICUs. Participants selected controls randomly on a 1:1 basis among all noncase patients stayed during the same period in ICUs. Data on 139 cases and 140 controls were deemed eligible. Among the controls, 69 patients died. The stratified Fine-Gray model was used to estimate the subdistribution Hazard ratios. The subdistribution hazards and 95% confidence intervals for final covariates were as follows: prior exposure to antimycotic agents, 2.21 (1.56-3.14); prior exposure to N-acetylcysteine, 0.11 (0.03-0.34) and prior surgical intervention, 1.26 (0.76-2.11). Of the patients, those exposed to antimycotic drugs, 87.1% (54/62) had breakthrough candidemia. Serious renal, hepatic, or hematologic side effects were comparable between patients those exposed and not-exposed to systemic antimycotic drugs. Untargeted administration of antimycotic drugs did not improve survival among candidemic patients (not-exposed, 63.6% [49/77]; exposed % 66.1 [41/62]; P = .899). This study documented that exposure to an antifungal agent is associated with increased the risk of subsequent development of CBSIs among nonneutropenic adult patients admitted to the ICU. Only two centers regularly prescribed N-acetylcysteine. Due to the limited number of subjects, we interpreted the positive effect of N-acetylcysteine on the absolute risk of CBSIs with caution.
dc.identifier.citationArslan, F., Çaşkurlu, H., Sarı, S., Çankar Dal, H., Turan, S., Ertürk Şengel, B. ... Vahaboğlu, H. (2019). Risk factors for noncatheter-related Candida bloodstream infections in intensive care units: A multicenter case-control study. Medical Mycology, 57(6), 668-674. https://doi.org/10.1093/mmy/myy127
dc.identifier.doi10.1093/mmy/myy127
dc.identifier.endpage674
dc.identifier.issn1369-3786
dc.identifier.issn1460-2709
dc.identifier.issue6
dc.identifier.scopusqualityQ1
dc.identifier.startpage668
dc.identifier.urihttps://doi.org/10.1093/mmy/myy127
dc.identifier.urihttps://hdl.handle.net/20.500.12511/4800
dc.identifier.volume57
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherOxford Univ Press
dc.relation.ispartofMedical Mycologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/embargoedAccess
dc.subjectCandidemia
dc.subjectCandida
dc.subjectIntensive Care Units
dc.subjectCase-Control Studies
dc.subjectRisk Factors
dc.titleRisk factors for noncatheter-related Candida bloodstream infections in intensive care units: A multicenter case-control study
dc.typeArticle

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