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Critical Care

, 14:R98

First Online: 27 May 2010Received: 03 March 2010Revised: 14 April 2010Accepted: 27 May 2010

Abstract

IntroductionCandidemia raises numerous therapeutic issues for intensive care physicians. Epidemiological data that could guide the choice of initial therapy are still required. This analysis sought to compare the characteristics of intensive care unit ICU patients with candidemia due to non-albicansCandida species with those of ICU patients with candidemia due to Candidaalbicans.

MethodsA prospective, observational, multicenter, French study was conducted from October 2005 to May 2006. Patients exhibiting candidemia developed during ICU stay and exclusively due either to one or more non-albicans Candida species or to C. albicans were selected. The data collected included patient characteristics on ICU admission and at the onset of candidemia.

ResultsAmong the 136 patients analyzed, 78 57.4% had candidemia caused by C. albicans. These patients had earlier onset of infection 11.1 ± 14.2 days after ICU admission vs. 17.4 ± 17.7, p = 0.02, higher severity scores on ICU admission SOFA: 10.4 ± 4.7 vs. 8.6 ± 4.6, p = 0.03; SAPS II: 57.4 ± 22.8 vs. 48.7 ± 15.5, P = 0.015, and were less often neutropenic 2.6% vs. 12%, p = 0.04 than patients with candidemia due to non-albicans Candida species.

ConclusionsAlthough patients infected with Candida albicans differed from patients infected with non-albicans Candida species for a few characteristics, no clinical factor appeared pertinent enough to guide the choice of empirical antifungal therapy in ICU.

AbbreviationsAmarCand-Analyse du Management en Anesthésie et Réanimation des Candidoses invasives-

HIVhuman immunodeficiency virus

ICUintensive care unit

MICminimum inhibitory concentration

SAPSsimplified acute physiology score

SOFAsepsis-related organ failure assessment

UCurinary catheter.

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Autor: Olivier Leroy - Jean-Paul Mira - Philippe Montravers - Jean-Pierre Gangneux - Olivier Lortholary - the AmarCand Study Group

Fuente: https://link.springer.com/



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