Analysis of Risk Factors Associated with Candidemia Among Patients with or without COVID-19 in Intensive Care Units During the Pandemic Process: A Multicenter Study
Introduction: The objective of this study was to compare the risk factors and mortality rates of candidemia among patients with and without COVID-19 in the intensive care units (ICU). Materials and Methods: This study is a retrospective multicenter observational study, in ICUs of 12 hospitals (eight tertiary and four secondary hospitals) in Türkiye. All adult patients (<18 years) hospitalized in ICUs and developed candidemia between 01.01.2020- 31.12.2021 were included. The following data were collected: age, gender, nasopharyngeal swab SARS-CoV-2 PCR test, species of Candida (Candida albicans or non-albicans Candida), comorbidities, ICU stay, antibiotic use, corticosteroid, and anti-cytokine therapy, central venous catheter (CVC), abdominal surgery, parenteral nutrition, mechanical ventilation (MV), other cultures isolated Candida spp., echocardiography (ECO), mortality. Data from patients with or without COVID-19 were compared. Results: A total of 188 patients, 66 COVID-19 and 122 non-COVID-19, were included in the study. The median age of the patients was 69.5 and there were no differences between the groups. 185 (98.4%) patients had a history of antibiotic use. Sixteen patients, all from the COVID-19 group, had a history of anti-cytokine therapy. Corticosteroid use was higher in COVID-19 patients (p< 0.001). Intraabdominal surgery was higher in the non-COVID-19 group (p< 0.014). C. albicans was isolated from 36.7% of total patients and the remaining were non-albicans Candida species. The overall mortality was higher in COVID-19 patients (p= 0.014). Alzheimer’s and malignancies were higher in non-COVID-19 patients. Intraabdominal surgery, MV, and CVC were higher in tertiary care hospitals whereas parenteral nutrition was higher in secondary care hospitals. Conclusion: Immunosuppressive treatments administered to COVID-19 patients pose a risk in terms of candidemia. Risk factors may differ between secondary and tertiary care hospitals. Preventable risk factors should be determined on a hospital basis and appropriate infection control measures should be taken..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
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| Enthalten in: |
Flora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi - 28(2023), 3, Seite 456-465 |
| Sprache: |
Englisch ; Türkisch |
|---|
| Beteiligte Personen: |
Taliha Karakök [VerfasserIn] |
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| Links: |
doi.org [kostenfrei] |
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| Themen: |
Candidemia |
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| doi: |
10.5578/flora.20239716 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
DOAJ095086110 |
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| 520 | |a Introduction: The objective of this study was to compare the risk factors and mortality rates of candidemia among patients with and without COVID-19 in the intensive care units (ICU). Materials and Methods: This study is a retrospective multicenter observational study, in ICUs of 12 hospitals (eight tertiary and four secondary hospitals) in Türkiye. All adult patients (<18 years) hospitalized in ICUs and developed candidemia between 01.01.2020- 31.12.2021 were included. The following data were collected: age, gender, nasopharyngeal swab SARS-CoV-2 PCR test, species of Candida (Candida albicans or non-albicans Candida), comorbidities, ICU stay, antibiotic use, corticosteroid, and anti-cytokine therapy, central venous catheter (CVC), abdominal surgery, parenteral nutrition, mechanical ventilation (MV), other cultures isolated Candida spp., echocardiography (ECO), mortality. Data from patients with or without COVID-19 were compared. Results: A total of 188 patients, 66 COVID-19 and 122 non-COVID-19, were included in the study. The median age of the patients was 69.5 and there were no differences between the groups. 185 (98.4%) patients had a history of antibiotic use. Sixteen patients, all from the COVID-19 group, had a history of anti-cytokine therapy. Corticosteroid use was higher in COVID-19 patients (p< 0.001). Intraabdominal surgery was higher in the non-COVID-19 group (p< 0.014). C. albicans was isolated from 36.7% of total patients and the remaining were non-albicans Candida species. The overall mortality was higher in COVID-19 patients (p= 0.014). Alzheimer’s and malignancies were higher in non-COVID-19 patients. Intraabdominal surgery, MV, and CVC were higher in tertiary care hospitals whereas parenteral nutrition was higher in secondary care hospitals. Conclusion: Immunosuppressive treatments administered to COVID-19 patients pose a risk in terms of candidemia. Risk factors may differ between secondary and tertiary care hospitals. Preventable risk factors should be determined on a hospital basis and appropriate infection control measures should be taken. | ||
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