A risk factor analysis of healthcare-associated fungal infections in an intensive care unit: a retrospective cohort study

Yang, Shi‐Ping; Chen, Yin Yin; Hsu, Han Shui; Wang, Fu Der; Chen, Liang yu; Fung, Chang Phone

doi:10.1186/1471-2334-13-10

Cited by 63 publications

(45 citation statements)

References 42 publications

(57 reference statements)

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“…Known risk factors for deep Candida infection include deposition of live Candida into the body, artificial ventilation, high Acute Physiology and Chronic Health Evaluation (APACHE) II score, use of broad‐spectrum antimicrobials, use of immunosuppressants, central venous catheter use, total parenteral nutrition, neutropenia (<500/mm 3 ), recent surgery (especially gastrointestinal surgery), renal failure, hemodialysis, malnutrition, severe acute pancreatitis, diabetes, recent organ transplantation, indwelling urinary catheter use, advanced age, chemotherapy, malignant tumor presence, and the use of antacids 68, 69, 70, 71. The combined use of anticandidal drugs as well as conventional antimicrobials should be considered when handling sepsis cases involving patients exhibiting more than one of these risk factors.…”

Section: Introductionmentioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

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Background and PurposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ), and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two‐thirds (>66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J‐SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation and its supporting evidence were also added to each recommendation statement. We conducted meta‐analyses for 29 CQs. Thirty seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for 5 CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese‐specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non‐specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals.

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Section: Introductionmentioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

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“…Candida biofi lms have been detected on ureteral stents and have been shown to grow in this lifestyle on experimentally on vaginal mucosa (Reid et al 1992 ;Harriott et al 2010 ). Urinary catheters are also a signifi cant risk factor in intensive care units for healthcare associated fungal infections (Yang et al 2013 ). Moreover, they are commonly detected on intrauterine contraceptives (Chassot et al 2008 ).…”

Section: Gastrointestinal and Urinary Tractmentioning

confidence: 98%

Fungal Biofilms in Human Disease

Williams

Ramage

2014

Advances in Experimental Medicine and Biology

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“…1 Beberapa penelitian epidemiologi menunjukkan telah terjadi peningkatan angka kejadian infeksi jamur selama 10 tahun terakhir.Studi Extended Prevalence of Infection in Intensive Care (EPIC II) tahun 2007 menyebutkan angka kandidiasis invasif adalah 17%, peringkat ketiga setelah infeksi Staphylococcus aureus dan Pseudomonas sp. 2 Karakteristik geografis suatu wilayah berperan didalam distribusi spesies jamur candida penyebab infeksi. Wilayah Australia, Amerika Utara dan Selatan spesies utama penyebab infeksi adalah Candida Glabrata, sedangkan di benua Eropa, Candida Albicans merupakan isolat utama penyebab infeksi.…”

Section: Pendahuluanunclassified

Faktor-Faktor yang Berhubungan dengan Mortalitas 30 Hari pada Pasien Sakit Kritis dengan Kandidiasis Invasif yang Dirawat di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSCM)

Ardian¹,

Pitoyo²,

Adhitianingsih³

et al. 2017

JPDI

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Pendahuluan. Tingkat mortalitas kandidiasis invasif mencapai 30-70%. Setiap studi menunjukkan tingkat mortalitas yang berbeda pada studi dan sampel yang berbeda. Belum ada data mengenai profil dan analisis faktor mortalitas kandidiasis invasif pada pasien sakit kritis. Studi ini bertujuan untuk memberikan informasi profil kandidiasis invasif pada pasien sakit kritis beserta faktor faktor yang berpengaruh terhadap mortalitas sebagai upaya untuk meningkatkan kualitas tata laksana pasien sakit kritis dengan kandidiasis invasif.Metode. Desain penelitian adalah potong lintang, mengumpulkan data dari rekam medis pada seratus dua pasien sakit kritis dengan kandidiasis invasif. Pasien kandidiasis invasif adalah pasien dengan hasil kultur darah dan atau kultur cairan tubuh normal steril positif jamur spesies Candida. Data yang dikumpulkan meliputi data usia, spesies jamur candida penyebab, faktor risiko kandidiasis invasif, serta data faktor yang berpengaruh terhadap mortalitas yang meliputi ada tidaknya kondisi sepsis, nilai APACHE, ada tidaknya kondisi gagal napas,ada tidaknya gagal ginjal, waktu pemberian terapi antijamur,Charlson Index, dan tempat perawatan (ICU atau Non ICU). Uji analisis bivariat dengan uji chi square dilakukan terhadap masing masing faktor, yang dilanjutkan dengan uji multivariat regresi logistik untuk menilai faktor yang paling berhubungan terhadap mortalitas 30 hari.Hasil. Dari 102 sampel penelitian didapatkan laki laki 52,9% dan perempuan 47,1%. Median usia 53 tahun dengan angka mortalitas 68,6%. Spesies candida penyebab terbanyak adalah Candida tropicalis (34,3%) dan Candida parapsilosis (29,4%), tiga faktor risiko kandidiasis invasif terkait penyakit dasar adalah sepsis (78,9%), keganasan (42,15%), diabetes melitus ( 29,4%) sedangkan yang terkait terapi atau tata laksana adalah penggunaan antibiotik spektrum luas (99%), kateter vena sentral (77,5%), serta pemberian nutrisi parenteral (70,6%). Pada analisis multivariat regresi logistik, faktor yang paling berpengaruh terhadap mortalitas adalah sepsis berat ( p 0,001, OR 7,7, IK95% 2,4 – 24,7), Charlson Index ≥ 3 ( p 0,022, OR 3,5, IK95% 1,2 – 10,2), dan gagal napas (p 0,066, OR 2,733 IK95% 0,9 – 8,0).Simpulan. Pada pasien sakit kritis dengan kandidiasis invasif yang dirawat di RSCM, laki laki lebih banyak dari pada perempuan, dengan median usia 53 tahun, dan angka mortalitas 68,6%. Spesies candida terbanyak penyebab infeksi adalah Candida tropicalis dan Candida parapsilosis. Faktor risiko kandidiasis invasif terbanyak terkait penyakit dasar adalah sepsis sedangkan terkait terapi atau tata laksana adalah penggunaan antibiotik spektrum luas. Faktor faktor yang berhubungan dengan mortalitas 30 hari adalah kondisi sepsis berat dan Charlson index ≥3.Kata Kunci: faktor mortalitas, kandidiasis invasif, sakit kritis Factors Related to 30 day Mortality in Critically Ill Patients with Invasive Candidiasis in Cipto Mangunkusumo HospitalIntroduction. Mortality rate of invasive candidiasis is still high, approximately 30-70%. Every study has a variety mortality rate depend on study design and sample. There is no data in Indonesia about profile and mortality factors analysis in critically ill patients with invasive candidiasis. Methods. The Study design was cross sectional. We studied 102 hospitalized critically ill patients with invasive candidiasis. The demographic, clinical and laboratory data, the risk factors for invasive candidiasis and the outcome of each patient in 30 days were recorded. An analysis bivariate with chi square or Fisher’s test was carried out to analyse some factors such as age > 60 years old, severe sepsis, APACHE score > 20, respiratory failure, renal failure, delayed antifungal treatment > 72 hours after positive culture, Charlson index score, and ICU or non ICU patients. The logistic regression of multivariate analysis was carried out to identify the most influence of all mortality factors. Results. Among 102 identified sample, the majority was male (52.9%), the median age was 53 years old and the mortality rate was 68,6%. Laboratory candida findings came from blood sample (candidemia) (98.03%), liquor cerebrospinal (1.5%) and retina exudate (1.5%). The most common candida species were candida non albicans especially Candida tropicalis (34.3%) and Candida parapsilosis (34.3%). The risk factors for invasive candidiasis from this study related to underlying disease were sepsis (78.9%), malignancy (42.15%), diabetes mellitus (29.4%) and related to therapy or treatment were the usage of broad spectrum antibiotic (99%), central vein catheter (77.5%), and parenteral nutrition (70.6%). The result from multivariate analysis, severe sepsis (p 0.001, OR 7.7, IK95% 2.4 – 24.7), Ch arlson Index ≥3 (p 0.022, OR 3.5, IK95% 1.2–10.2), and respiratory failure (p 0.066, OR 2.7 IK95% 0.9 – 8.0) were independently associated with mortality. Conclusions. In Cipto Mangunkusumo hospital, most critically ill patients with invasive candidiasis was male, median age was 53 years old, and mortality rate was 68,6%. The most species candida caused infection were Candida tropicalis and Candida parapsilosis. The most risk factors of invasive candidiasis from underlying disease was sepsis and from the treatment was the usage of broad spectrum antibiotic. Severe sepsis, and Charlson index ≥3 were associated with a 30 day mortality in critically ill patients with invasive candidiasis.

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A risk factor analysis of healthcare-associated fungal infections in an intensive care unit: a retrospective cohort study

Cited by 63 publications

References 42 publications

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Fungal Biofilms in Human Disease

Faktor-Faktor yang Berhubungan dengan Mortalitas 30 Hari pada Pasien Sakit Kritis dengan Kandidiasis Invasif yang Dirawat di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSCM)

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