NOLLA J, EPCAN PROJECT G; Interscience Conference on Antimicrobial Agents and Chemotherapy.

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 563 (abstract no. 978).

Hosp. Univ. Del Mar, Barcelona, SPAIN.

BACKGROUND: to evaluate risk factors for IFI in non-neutropenic, critically ill patients (pts).METHODS: We conducted a prospective, multicenter study from 5/98 to 1/99 in pts staying > 7 days in 70 Spanish Intensive Care Units (ICU). Surveillance cultures were performed weekly from: urine, tracheal aspirate, oropharynx, and gastric aspirate. The pts were catalogued in two groups: colonized (appearance or persistence of fungi in surveillance cultures) and IFI (isolation from a sterile body site +/- fungemia+/- endopthalmitis +/- organ biopsy).RESULTS: We analyzed 526 pts consecutive pts: 243 pts (46.3%) in colonized group and 41 pts (7.9%) in IFI group (fungemia: 24 pts, endophtalmitis: 5 pts, peritoneal or pleural cavity: 12 pts, wound infection: 7 pts). A total of 981/4476 (21.9%) cultures were positive to fungi: predominant species of Candida found were C. albicans, 72.3%; C. non-albicans: 13.3%; and Candida spp, 5.6%. Aspergillus spp was isolated in 10 cultures (1%) and other fungi in 59 (6%). Both groups were similar with respect to age, gender, APACHE II score at admission, length of ICU stay, use of immunosuppresive therapy, central lines, neutropenia, foley catheter and ventilator. In univariate analysis, surgical pts, use of broad spectrum antibiotics, parenteral nutrition, extrarenal depuration, and surgical procedure during ICU stay, were factors significantly associated to developing IFI. Use of steroids, medical or traumatologic pts, and neurologic or respiratory inssuficiency at admission, were factors significantly associated with colonized group. ICU mortality was significantly higher in IFI groups (61%), than colonized group (36%; p < 0.01). The only significant independent risk factors associated with IFI, using a multivariate analysis were: parenteral nutrition (p<0.003) and extrarenal depuration (p < 0.05).CONCLUSION: A restrictive use of parenteral nutrition and extrarenal depuration in non-neutropenic, critically ill pts could avoid invasive fungal infection development.

Publication Types:

• Meeting Abstracts

Keywords:

• Candida
• Candidiasis
• Critical Illness
• Fungemia
• Fungi
• Humans
• Intensive Care Units
• Mycoses
• Neutropenia
• Oropharynx
• Prospective Studies
• Risk Factors

Other ID:

• GWAIDS0009369

UI: 102246867

From Meeting Abstracts