Predictors of outcomes in patients with candidemia in an Intensive Care Unit

Abstract

Objective: Candidemia is a life-threatening infection that causes high mortality rates in intensive care units (ICUs). This study aims to evaluate predictors of the outcome of patients with candidemia in ICU. Patients and Methods: This observational, retrospective study included patients with Candida bloodstream infection (BSI) in ICUs between 6 years of the episode. A binary logistic regression analysis was conducted to inspect the association with mortality. Results: The median age of 74 patients was 68.5, and 53.8% were men. C. parapsilosis was the most frequently isolated fungal species. The 30-day mortality rate was 50%. In the logistic regression model the Acute Physiology and Chronic Health Evaluation (APACHE) II score, positive blood culture on the seventh day, inotropes needed on the day of blood culture positivity, and ventilator-associated pneumonia (VAP) were significant risk factors for the outcome of patients. There was no difference in mortality between an early start of antifungal treatment or central venous catheter removal time. Conclusion: A shift to C. parapsilosis is observed in this study. Host-related factors such as APACHE II score, need for mechanical ventilation or need for inotropes affect mortality more than early treatment and source control in patients with Candida BSI.