Frequency, mortality and risk factors of candidemia at a tertiary care hospital

Abstract

Aims: To study the relationship between myocardial release of cTnI and myocardial cell death as assessed by the amount of apoptosis and necrosis after cardiac surgery. Methods: Eighteen young pigs were operated on with standardized cardiopulmonary bypass (CPB). Release of cTnI in the cardiac lymph (CL), coronary sinus (CS), and arterial blood (A) was related to postoperative myocardial cell death by both necrosis and apoptosis. Apoptotic cells were detected by a TUNEL detection kit. Necrotic cells were counted by light microscopy. Results: In all animals, cTnI was significantly released and reached peak values observed simultaneously in A (cTnI, 20.1±2.6 ng/ml) (mean ±SEM), CS (19.5±3.2 ng/ml) and CL (5202±2500 ng/ml). Percentage of total myocardial cell death was 3.1±0.5%, including 1.2±0.35% necrosis and 1.9±0.5% apoptosis. cTnI release during and after CPB did not correlate with the degree of myocardial apoptosis or necrosis. Conclusion: Cardiac operations with CPB are related to myocardial cell damage including myocardial cell death due to both necrosis and apoptosis. As the loss of cTnI is not related to the amount of cell death, our results suggest that increased cardiac myocyte membrane permeability more than cell death is responsible for intraoperative and postoperative cTnI release.

Infection Control in the ICU

“…142 However, recent data suggest that this incidence may be stable in some other institutions. 143,144 The emergence of serious infections related to Candida glabrata and Candida krusei, which are mostly resistant to triazoles (fluconazole and itraconazole), was reported [145][146][147][148] by bone-marrow transplant centers and some ICUs, where the proportion of these strains may represent Ͼ 50% of isolates from colonized patients. However, no such evolution has been reported 23,149,150 in other institutions where the use of triazole prophylaxis was restricted to high-risk patients.…”