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Nosocomial candidemia in patients admitted to medicine wards compared to other wards: a multicentre study
- Publication Year :
- 2016
-
Abstract
- PURPOSE: Risk factors for nosocomial candidemia, severity of sepsis, treatment, and outcome were compared between patients admitted to medicine wards and those to surgical and intensive care units (ICUs). METHODS: Data were retrospectively collected from patients belonging to six referral hospitals in Italy between January 2011 and December 2013. Risk factors for 30-day mortality were evaluated in the whole patient population. RESULTS: A total of 686 patients (mean age 70 ± 15 years) with candidemia were included. 367 (53.5 %) patients were in medicine wards, and 319 in surgery and ICUs. Host-related risk factors for candidemia were more common in medicine patients whereas healthcare-related factors in surgery/ICU patients. These patients showed severe sepsis and septic shock more commonly (71.7 %) than medicine patients (59.9 %) (p 0.003). The latter underwent central venous catheter (CVC) removal and adequate antifungal therapy less frequently than surgery/ICU patients. 149 (40.6 %) patients died with candidemia in medicine wards and 69 (21.6 %) in other wards (p < 0.001). Overall, the 30-day mortality was 36.3 %. At multivariate analysis, independent risk factors for death were aging, higher Charlson score, severe sepsis and septic shock, and no antifungal therapy, while major surgery and CVC removal were associated with higher probability of survival. CONCLUSIONS: The burden of risk factors for candidemia was different between medicine patients and those in other wards. Despite the lower severity of candidemia in medicine patients, their mortality turned out to be higher than in surgery or ICU patients. Awareness of the best management of candidemia should be pursued, especially in medicine wards.
- Subjects :
- Male
0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
Multivariate analysis
Referral
Epidemiology
medicine.medical_treatment
030106 microbiology
Sepsis
Candidemia
Elderly
Medicine wards
Mortality
Risk factors
Aged
Aged, 80 and over
Cross Infection
Female
Hospital Units
Humans
Italy
Retrospective Studies
Risk Factors
Infectious Diseases
03 medical and health sciences
0302 clinical medicine
Intensive care
80 and over
Medicine
030212 general & internal medicine
Medicine ward
business.industry
Septic shock
Retrospective cohort study
General Medicine
medicine.disease
Emergency medicine
Risk factor
business
Central venous catheter
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....40ad3d6cadbcba05384fd545bf012df5