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Volume 3 Supplement 1

ESICM LIVES 2015

Clinical characteristics, outcomes and risk factors of candidial infections with critically ill patients in respiratory intensive care unit in turkey

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Objectives

Candidial infection is associated with high mortality in critically ill patients. Fungal infections compose a major problem in intensive care units in both developed and developing countries. Candidemia is associated with a prolonged hospital stay, resulting in increasedcosts, and high mortality.

Methods

This study was conducted in a 12-bed adult respiratory intensive care unit (>18 years). Clinical and laboratory data from patients with candidial infection were collected retrospectively.

Results

Median age was 70.1 ± 14.60 years (min 18 years, max 91 years). The median APACHE II score on admission was 21.28 ± 5.39. A total of 405 episodes were identified from 2007 to 2014. The rates of candidial infections were urinary tract infection (67.6%), blood stream infection (23.5%) and pneumonia (8.9%). The fungi identified were yeast (54.32%), C. albicans (26.40%), C. tropicalis (5.91%), C. glabrata (6.91%), C. parapsilosis (3.20%), C. krusei (1.23%), Candida kefyr (0.98%) and other Candida species (1.23%) (Table1). Candida albicans accounted for 57.29% of all Candida species. Fluconazole resistance was found in 35.42%. The susceptibility to amphotericine B was 96.94%. Itraconazole resistance was 70.22%. None of all patiens was using previously antifungal therapy. Primary therapy included monotherapy with fluconazole (n = 99), caspofungin (n = 14), anidulafungin (n = 8) and voriconazole (n = 8). Combination therapy was infrequently used (n = 6). The mortality rate was 77.6% (n = 184). The use of broad-spectrum antibiotics was 85.2%. The presence of an intravascular device was 70% (n = 164). The use of parenteral (n = 66), enteral nutrition (n = 46) and both (n = 98) were 27.8%, 19.4% and 41.4% respectively. The median mechanic ventilation days were 13.3 ± 15.96 days. The median RICU length of stay (LOS) was 24.8 ± 24.19 days. The most patients (61.18%) came to RICU from other departments and care units.

Conclusions

In conclusion, candidial infections associated with high mortality, APACHE II score, LOS, ventilation days and use of broad-spectrum antibiotics.

Table 1 Candida Species in Culture Types.

Author information

Correspondence to K Uzun.

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Erayman, İ., Yavşan, D., Altuntaş, R. et al. Clinical characteristics, outcomes and risk factors of candidial infections with critically ill patients in respiratory intensive care unit in turkey. ICMx 3, A1011 (2015) doi:10.1186/2197-425X-3-S1-A1011

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Keywords

  • Fluconazole
  • Candida Albicans
  • Itraconazole
  • Voriconazole
  • Enteral Nutrition