Comparison of the epidemiology, risk factors, outcome and degree of organ failures of patients with candidemia acquired before or during ICU treatment
The aim of this study was to compare the epidemiology, risk factors, severity and outcome of two types of ICU-treated candidemias: namely, ICU-acquired candidemia (acquired after 48-hour ICU stay) (ICUAC group), and those needing ICU treatment for candidemia acquired before ICU admission or during t...
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| Veröffentlicht in: | Critical care (London, England) England), 2012-04, Vol.16 (2), p.R62-R62, Article R62 |
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| creator | Ylipalosaari, Pekka Ala-Kokko, Tero I Karhu, Juha Koskela, Markku Laurila, Jouko Ohtonen, Pasi Syrjälä, Hannu |
| description | The aim of this study was to compare the epidemiology, risk factors, severity and outcome of two types of ICU-treated candidemias: namely, ICU-acquired candidemia (acquired after 48-hour ICU stay) (ICUAC group), and those needing ICU treatment for candidemia acquired before ICU admission or during the first 48-hour ICU stay (non-ICUAC group).
A retrospective cohort study was conducted between 2000 and 2009 in a mixed tertiary ICU among patients with blood-culture-confirmed candidemia.
The study involved 82 patients (53 men). The ICUAC group consisted of 38 patients (46.3%) and the non- ICUA group included 44 patients (53.6). The ICUAC group had undergone previous surgery more often and had ICU stays that were 3.7 times longer than the non-ICUAC group, whose members more often had co-morbidities (95.6% versus 73.7%, P = 0.001). The ICUAC group had significantly more frequent organ failures with cardiovascular, renal, central nervous and coagulation systems than the non-ICUAC group. ICU, hospital and one-year mortality rates did not differ between the groups (23%, 36.8% and 65.8%, respectively, in the ICUAC group and 26%, 44.4% and 64.4%, respectively, in the non-ICUAC group). Among patients with APACHE II scores greater than 25, the ICUAC group had lower one-year mortality (65.0% versus 87.5%). Among patients with APACHE II scores of 25 or less, the ICUAC group had higher mortality (66.7% versus 50.0). Candida albicans was most common cause of candidemia in both groups (76.3% and 68.9%, respectively).
More than half of the ICU-treated candidemias were acquired prior to admission to the ICU. Patients with ICU- and non-ICU-acquired candidemias had different risk factors and different needs for ICU resources. Hospital mortality was similar in both groups; however, the groups had different mortality rates when the severity of disease and underlying diseases were taken into account. |
| doi_str_mv | 10.1186/cc11307 |
| format | Article |
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A retrospective cohort study was conducted between 2000 and 2009 in a mixed tertiary ICU among patients with blood-culture-confirmed candidemia.
The study involved 82 patients (53 men). The ICUAC group consisted of 38 patients (46.3%) and the non- ICUA group included 44 patients (53.6). The ICUAC group had undergone previous surgery more often and had ICU stays that were 3.7 times longer than the non-ICUAC group, whose members more often had co-morbidities (95.6% versus 73.7%, P = 0.001). The ICUAC group had significantly more frequent organ failures with cardiovascular, renal, central nervous and coagulation systems than the non-ICUAC group. ICU, hospital and one-year mortality rates did not differ between the groups (23%, 36.8% and 65.8%, respectively, in the ICUAC group and 26%, 44.4% and 64.4%, respectively, in the non-ICUAC group). Among patients with APACHE II scores greater than 25, the ICUAC group had lower one-year mortality (65.0% versus 87.5%). Among patients with APACHE II scores of 25 or less, the ICUAC group had higher mortality (66.7% versus 50.0). Candida albicans was most common cause of candidemia in both groups (76.3% and 68.9%, respectively).
More than half of the ICU-treated candidemias were acquired prior to admission to the ICU. Patients with ICU- and non-ICU-acquired candidemias had different risk factors and different needs for ICU resources. Hospital mortality was similar in both groups; however, the groups had different mortality rates when the severity of disease and underlying diseases were taken into account.</description><identifier>ISSN: 1364-8535</identifier><identifier>EISSN: 1466-609X</identifier><identifier>EISSN: 1364-8535</identifier><identifier>DOI: 10.1186/cc11307</identifier><identifier>PMID: 22512852</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Aged ; Antifungal Agents - therapeutic use ; Candidemia - drug therapy ; Candidemia - epidemiology ; Candidemia - microbiology ; Candidiasis ; Care and treatment ; Comorbidity ; Comparative analysis ; Computer software industry ; Cross Infection - epidemiology ; Female ; Finland - epidemiology ; Hospital Mortality ; Humans ; Incidence ; Intensive Care Units ; Length of Stay - statistics & numerical data ; Male ; Mergers, acquisitions and divestments ; Middle Aged ; Multiple Organ Failure - epidemiology ; Multiple Organ Failure - microbiology ; Patient outcomes ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Survival Rate</subject><ispartof>Critical care (London, England), 2012-04, Vol.16 (2), p.R62-R62, Article R62</ispartof><rights>COPYRIGHT 2012 BioMed Central Ltd.</rights><rights>Copyright ©2012 Ylipalosaari et al.; licensee BioMed Central Ltd. 2012 Ylipalosaari et al.; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b487t-339c979d3c49255e1dd401276c75e73c6d2d43525d65a4d8272f95c1cb369eaa3</citedby><cites>FETCH-LOGICAL-b487t-339c979d3c49255e1dd401276c75e73c6d2d43525d65a4d8272f95c1cb369eaa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681391/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681391/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22512852$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ylipalosaari, Pekka</creatorcontrib><creatorcontrib>Ala-Kokko, Tero I</creatorcontrib><creatorcontrib>Karhu, Juha</creatorcontrib><creatorcontrib>Koskela, Markku</creatorcontrib><creatorcontrib>Laurila, Jouko</creatorcontrib><creatorcontrib>Ohtonen, Pasi</creatorcontrib><creatorcontrib>Syrjälä, Hannu</creatorcontrib><title>Comparison of the epidemiology, risk factors, outcome and degree of organ failures of patients with candidemia acquired before or during ICU treatment</title><title>Critical care (London, England)</title><addtitle>Crit Care</addtitle><description>The aim of this study was to compare the epidemiology, risk factors, severity and outcome of two types of ICU-treated candidemias: namely, ICU-acquired candidemia (acquired after 48-hour ICU stay) (ICUAC group), and those needing ICU treatment for candidemia acquired before ICU admission or during the first 48-hour ICU stay (non-ICUAC group).
A retrospective cohort study was conducted between 2000 and 2009 in a mixed tertiary ICU among patients with blood-culture-confirmed candidemia.
The study involved 82 patients (53 men). The ICUAC group consisted of 38 patients (46.3%) and the non- ICUA group included 44 patients (53.6). The ICUAC group had undergone previous surgery more often and had ICU stays that were 3.7 times longer than the non-ICUAC group, whose members more often had co-morbidities (95.6% versus 73.7%, P = 0.001). The ICUAC group had significantly more frequent organ failures with cardiovascular, renal, central nervous and coagulation systems than the non-ICUAC group. ICU, hospital and one-year mortality rates did not differ between the groups (23%, 36.8% and 65.8%, respectively, in the ICUAC group and 26%, 44.4% and 64.4%, respectively, in the non-ICUAC group). Among patients with APACHE II scores greater than 25, the ICUAC group had lower one-year mortality (65.0% versus 87.5%). Among patients with APACHE II scores of 25 or less, the ICUAC group had higher mortality (66.7% versus 50.0). Candida albicans was most common cause of candidemia in both groups (76.3% and 68.9%, respectively).
More than half of the ICU-treated candidemias were acquired prior to admission to the ICU. Patients with ICU- and non-ICU-acquired candidemias had different risk factors and different needs for ICU resources. Hospital mortality was similar in both groups; however, the groups had different mortality rates when the severity of disease and underlying diseases were taken into account.</description><subject>Aged</subject><subject>Antifungal Agents - therapeutic use</subject><subject>Candidemia - drug therapy</subject><subject>Candidemia - epidemiology</subject><subject>Candidemia - microbiology</subject><subject>Candidiasis</subject><subject>Care and treatment</subject><subject>Comorbidity</subject><subject>Comparative analysis</subject><subject>Computer software industry</subject><subject>Cross Infection - epidemiology</subject><subject>Female</subject><subject>Finland - epidemiology</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Incidence</subject><subject>Intensive Care Units</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Mergers, acquisitions and divestments</subject><subject>Middle Aged</subject><subject>Multiple Organ Failure - epidemiology</subject><subject>Multiple Organ Failure - microbiology</subject><subject>Patient outcomes</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Survival Rate</subject><issn>1364-8535</issn><issn>1466-609X</issn><issn>1364-8535</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1ksFu1DAQhi0EoqUg3gBZ4sClKbEdOwkHpGpFoVIlLlTiZjnjSdaQxMF2QH0Rnhdvt1RdCeSDrZn_-z0eDyEvWXnGWKPeAjAmyvoROWaVUoUq26-P81moqmikkEfkWYzfypLVjRJPyRHnkvFG8mPye-OnxQQX_Ux9T9MWKS7O4uT86IebU5pT32lvIPkQT6lfE_gJqZkttTgExB3lw2DmLHLjGjDuIotJDucU6S-XthSy_NbTUAM_VhfQ0g57HzIdqF2Dmwd6ubmmKaBJUwafkye9GSO-uNtPyPXFhy-bT8XV54-Xm_OroquaOhVCtNDWrRVQtVxKZNZWJeO1glpiLUBZbishubRKmso2vOZ9K4FBJ1SLxogT8n7vu6zdhBby1cGMegluMuFGe-P0YWZ2Wz34n1qohomWZYN3e4PO-f8YHGZy-_Tdb2X49R4ezIjazb3PEphcBH0uRS685Exm1dk_VHntOgp-xt7l-AHwZg9A8DEG7O_LYaXejcuDAl49fP697u98iD8DBL4N</recordid><startdate>20120418</startdate><enddate>20120418</enddate><creator>Ylipalosaari, Pekka</creator><creator>Ala-Kokko, Tero I</creator><creator>Karhu, Juha</creator><creator>Koskela, Markku</creator><creator>Laurila, Jouko</creator><creator>Ohtonen, Pasi</creator><creator>Syrjälä, Hannu</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20120418</creationdate><title>Comparison of the epidemiology, risk factors, outcome and degree of organ failures of patients with candidemia acquired before or during ICU treatment</title><author>Ylipalosaari, Pekka ; Ala-Kokko, Tero I ; Karhu, Juha ; Koskela, Markku ; Laurila, Jouko ; Ohtonen, Pasi ; Syrjälä, Hannu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b487t-339c979d3c49255e1dd401276c75e73c6d2d43525d65a4d8272f95c1cb369eaa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Antifungal Agents - therapeutic use</topic><topic>Candidemia - drug therapy</topic><topic>Candidemia - epidemiology</topic><topic>Candidemia - microbiology</topic><topic>Candidiasis</topic><topic>Care and treatment</topic><topic>Comorbidity</topic><topic>Comparative analysis</topic><topic>Computer software industry</topic><topic>Cross Infection - epidemiology</topic><topic>Female</topic><topic>Finland - epidemiology</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Incidence</topic><topic>Intensive Care Units</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Mergers, acquisitions and divestments</topic><topic>Middle Aged</topic><topic>Multiple Organ Failure - epidemiology</topic><topic>Multiple Organ Failure - microbiology</topic><topic>Patient outcomes</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ylipalosaari, Pekka</creatorcontrib><creatorcontrib>Ala-Kokko, Tero I</creatorcontrib><creatorcontrib>Karhu, Juha</creatorcontrib><creatorcontrib>Koskela, Markku</creatorcontrib><creatorcontrib>Laurila, Jouko</creatorcontrib><creatorcontrib>Ohtonen, Pasi</creatorcontrib><creatorcontrib>Syrjälä, Hannu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Critical care (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ylipalosaari, Pekka</au><au>Ala-Kokko, Tero I</au><au>Karhu, Juha</au><au>Koskela, Markku</au><au>Laurila, Jouko</au><au>Ohtonen, Pasi</au><au>Syrjälä, Hannu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of the epidemiology, risk factors, outcome and degree of organ failures of patients with candidemia acquired before or during ICU treatment</atitle><jtitle>Critical care (London, England)</jtitle><addtitle>Crit Care</addtitle><date>2012-04-18</date><risdate>2012</risdate><volume>16</volume><issue>2</issue><spage>R62</spage><epage>R62</epage><pages>R62-R62</pages><artnum>R62</artnum><issn>1364-8535</issn><eissn>1466-609X</eissn><eissn>1364-8535</eissn><abstract>The aim of this study was to compare the epidemiology, risk factors, severity and outcome of two types of ICU-treated candidemias: namely, ICU-acquired candidemia (acquired after 48-hour ICU stay) (ICUAC group), and those needing ICU treatment for candidemia acquired before ICU admission or during the first 48-hour ICU stay (non-ICUAC group).
A retrospective cohort study was conducted between 2000 and 2009 in a mixed tertiary ICU among patients with blood-culture-confirmed candidemia.
The study involved 82 patients (53 men). The ICUAC group consisted of 38 patients (46.3%) and the non- ICUA group included 44 patients (53.6). The ICUAC group had undergone previous surgery more often and had ICU stays that were 3.7 times longer than the non-ICUAC group, whose members more often had co-morbidities (95.6% versus 73.7%, P = 0.001). The ICUAC group had significantly more frequent organ failures with cardiovascular, renal, central nervous and coagulation systems than the non-ICUAC group. ICU, hospital and one-year mortality rates did not differ between the groups (23%, 36.8% and 65.8%, respectively, in the ICUAC group and 26%, 44.4% and 64.4%, respectively, in the non-ICUAC group). Among patients with APACHE II scores greater than 25, the ICUAC group had lower one-year mortality (65.0% versus 87.5%). Among patients with APACHE II scores of 25 or less, the ICUAC group had higher mortality (66.7% versus 50.0). Candida albicans was most common cause of candidemia in both groups (76.3% and 68.9%, respectively).
More than half of the ICU-treated candidemias were acquired prior to admission to the ICU. Patients with ICU- and non-ICU-acquired candidemias had different risk factors and different needs for ICU resources. Hospital mortality was similar in both groups; however, the groups had different mortality rates when the severity of disease and underlying diseases were taken into account.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>22512852</pmid><doi>10.1186/cc11307</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Antifungal Agents - therapeutic use Candidemia - drug therapy Candidemia - epidemiology Candidemia - microbiology Candidiasis Care and treatment Comorbidity Comparative analysis Computer software industry Cross Infection - epidemiology Female Finland - epidemiology Hospital Mortality Humans Incidence Intensive Care Units Length of Stay - statistics & numerical data Male Mergers, acquisitions and divestments Middle Aged Multiple Organ Failure - epidemiology Multiple Organ Failure - microbiology Patient outcomes Proportional Hazards Models Retrospective Studies Risk Factors Severity of Illness Index Survival Rate |
| title | Comparison of the epidemiology, risk factors, outcome and degree of organ failures of patients with candidemia acquired before or during ICU treatment |
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