{"title":"使用糖皮质激素和肠外营养是导管相关念珠菌血流感染的风险因素：一项回顾性研究。","authors":"Lipeng Huang, Shanshan Li, Ronglin Jiang, Shu Lei, Jiannong Wu, Liquan Huang, Meifei Zhu","doi":"10.2478/abm-2024-0016","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Catheter-related candidemia (CRC) is a serious catheter-related bloodstream infection (CRBSI) caused by <i>Candida</i> spp., with higher mortality than CRBSIs caused by other organisms.</p><p><strong>Objective: </strong>To identify the risk factors for <i>Candida</i> CRBSI. The clinical characteristics of 297 patients with CRBSI in a local hospital from January 2007 to June 2015 were collected, including 33 <i>Candida</i> CRBSI and 264 non-<i>Candida</i> CRBSI.</p><p><strong>Method: </strong>The associations of <i>Candida</i> CRBSI with the clinical variables were examined using univariate and multivariate analyses.</p><p><strong>Results: </strong>Multivariate analysis showed that glucocorticoid use (odds ratio [OR] = 10.313, 95% confidence interval [CI] = 2.032-52.330, <i>P</i> = 0.005) and parenteral nutrition (OR = 5.400, 95% CI = 0.472-61.752, <i>P</i> = 0.0175) were independent risk factors for <i>Candida</i> CRBSI. The most prevalent species were <i>Candida tropicalis</i> (42.4%) and <i>Candida albicans</i> (36.36%). Of the 33 <i>Candida</i> CRBSI cases, 31 (93.93%) had indwelling central venous catheters (CVC) for ≥14 d. The mortality of <i>Candida</i> CRBSI was remarkably higher than that of bacteria CRBSI. Patients with timely catheter removal and appropriate antifungal treatment had dramatically increased 28-d survival compared with those with untimely catheter removal + inappropriate antifungal treatment (88.89% vs. 0, <i>P</i> = 0.006).</p><p><strong>Conclusion: </strong>The study identified glucocorticoid use and parenteral nutrition as independent risk factors for <i>Candida</i> CRBSI. The outcome of candidemia was associated with the duration of CVC indwelling and antifungal treatment.</p>","PeriodicalId":8501,"journal":{"name":"Asian Biomedicine","volume":null,"pages":null},"PeriodicalIF":0.4000,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11337845/pdf/","citationCount":"0","resultStr":"{\"title\":\"Glucocorticoid use and parenteral nutrition are risk factors for catheter-related <i>Candida</i> bloodstream infection: a retrospective study.\",\"authors\":\"Lipeng Huang, Shanshan Li, Ronglin Jiang, Shu Lei, Jiannong Wu, Liquan Huang, Meifei Zhu\",\"doi\":\"10.2478/abm-2024-0016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Catheter-related candidemia (CRC) is a serious catheter-related bloodstream infection (CRBSI) caused by <i>Candida</i> spp., with higher mortality than CRBSIs caused by other organisms.</p><p><strong>Objective: </strong>To identify the risk factors for <i>Candida</i> CRBSI. The clinical characteristics of 297 patients with CRBSI in a local hospital from January 2007 to June 2015 were collected, including 33 <i>Candida</i> CRBSI and 264 non-<i>Candida</i> CRBSI.</p><p><strong>Method: </strong>The associations of <i>Candida</i> CRBSI with the clinical variables were examined using univariate and multivariate analyses.</p><p><strong>Results: </strong>Multivariate analysis showed that glucocorticoid use (odds ratio [OR] = 10.313, 95% confidence interval [CI] = 2.032-52.330, <i>P</i> = 0.005) and parenteral nutrition (OR = 5.400, 95% CI = 0.472-61.752, <i>P</i> = 0.0175) were independent risk factors for <i>Candida</i> CRBSI. The most prevalent species were <i>Candida tropicalis</i> (42.4%) and <i>Candida albicans</i> (36.36%). Of the 33 <i>Candida</i> CRBSI cases, 31 (93.93%) had indwelling central venous catheters (CVC) for ≥14 d. The mortality of <i>Candida</i> CRBSI was remarkably higher than that of bacteria CRBSI. Patients with timely catheter removal and appropriate antifungal treatment had dramatically increased 28-d survival compared with those with untimely catheter removal + inappropriate antifungal treatment (88.89% vs. 0, <i>P</i> = 0.006).</p><p><strong>Conclusion: </strong>The study identified glucocorticoid use and parenteral nutrition as independent risk factors for <i>Candida</i> CRBSI. The outcome of candidemia was associated with the duration of CVC indwelling and antifungal treatment.</p>\",\"PeriodicalId\":8501,\"journal\":{\"name\":\"Asian Biomedicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.4000,\"publicationDate\":\"2024-06-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11337845/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asian Biomedicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2478/abm-2024-0016\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/6/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Biomedicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2478/abm-2024-0016","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
Glucocorticoid use and parenteral nutrition are risk factors for catheter-related Candida bloodstream infection: a retrospective study.
Background: Catheter-related candidemia (CRC) is a serious catheter-related bloodstream infection (CRBSI) caused by Candida spp., with higher mortality than CRBSIs caused by other organisms.
Objective: To identify the risk factors for Candida CRBSI. The clinical characteristics of 297 patients with CRBSI in a local hospital from January 2007 to June 2015 were collected, including 33 Candida CRBSI and 264 non-Candida CRBSI.
Method: The associations of Candida CRBSI with the clinical variables were examined using univariate and multivariate analyses.
Results: Multivariate analysis showed that glucocorticoid use (odds ratio [OR] = 10.313, 95% confidence interval [CI] = 2.032-52.330, P = 0.005) and parenteral nutrition (OR = 5.400, 95% CI = 0.472-61.752, P = 0.0175) were independent risk factors for Candida CRBSI. The most prevalent species were Candida tropicalis (42.4%) and Candida albicans (36.36%). Of the 33 Candida CRBSI cases, 31 (93.93%) had indwelling central venous catheters (CVC) for ≥14 d. The mortality of Candida CRBSI was remarkably higher than that of bacteria CRBSI. Patients with timely catheter removal and appropriate antifungal treatment had dramatically increased 28-d survival compared with those with untimely catheter removal + inappropriate antifungal treatment (88.89% vs. 0, P = 0.006).
Conclusion: The study identified glucocorticoid use and parenteral nutrition as independent risk factors for Candida CRBSI. The outcome of candidemia was associated with the duration of CVC indwelling and antifungal treatment.
期刊介绍：
Asian Biomedicine: Research, Reviews and News (ISSN 1905-7415 print; 1875-855X online) is published in one volume (of 6 bimonthly issues) a year since 2007. [...]Asian Biomedicine is an international, general medical and biomedical journal that aims to publish original peer-reviewed contributions dealing with various topics in the biomedical and health sciences from basic experimental to clinical aspects. The work and authorship must be strongly affiliated with a country in Asia, or with specific importance and relevance to the Asian region. The Journal will publish reviews, original experimental studies, observational studies, technical and clinical (case) reports, practice guidelines, historical perspectives of Asian biomedicine, clinicopathological conferences, and commentaries
Asian biomedicine is intended for a broad and international audience, primarily those in the health professions including researchers, physician practitioners, basic medical scientists, dentists, educators, administrators, those in the assistive professions, such as nurses, and the many types of allied health professionals in research and health care delivery systems including those in training.
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