C-Rosin

SIMIT 2015, Catania 8-11 novembre 2015
Le candidemie in una coorte di 686 pazienti
anziani del Triveneto: analisi dei fattori di
rischio per candidemia e mortalità
C. Rosin, A. Azzini , M. Merelli, S. Cavinato , P. Brugnaro, C. Vedovelli ,
C. Maurel, J. Monticelli, M. Busetti, P.Mian, A.M. Cattelan, E. Raise, F.
Ansaldi*, M. Bassetti, E. Concia, R. Luzzati e Triveneto SIMIT-group
Malattie Infettive degli Ospedali di Trieste, Verona, Udine, Padova,
Venezia-Mestre, Bolzano; *Ist. di Igiene, Università di Genova.
Dott.ssa Chiara Rosin
SC. Malattie Infettive (Trieste)
Introduction
• 40% to 60% of candidemia episodes were found in patients
admitted to internal medicine wards according to some
studies
• Critically ill individuals in intensive care units (ICUs) remained
the leading target population representing 41-48% of patients
with candidemia in other studies
• Although candidemia is more frequent among elderly
patients, available data on this growing patient population are
still limited
SIMIT 2015, Catania 8-11 novembre 2015
Objectives
• Aim of this study was to compare risk factors for
nosocomial candidemia, severity of sepsis, and
outcome between patients admitted to internal
medicine and specialized medical wards and those to
surgery and intensive care units (ICUs)
SIMIT 2015, Catania 8-11 novembre 2015
Methods
• This multicentre retrospective study includes patients affected by
nosocomial candidemia admitted to six public referral hospitals in 6
cities located in northeastern Italy between January 2011 and
December 2013
• Antifungal treatment was considered adequate when the infecting
Candida strain was ultimately shown to be susceptible and the
dosage of antifungals used was adequate within the first 48 h from
the onset of candidemia
• Crude mortality rate was calculate at 30 days from the diagnosis of
candidemia differentiating patients died with and without fungemia
SIMIT 2015, Catania 8-11 novembre 2015
SIMIT 2015, Catania 8-11 novembre 2015
SIMIT 2015, Catania 8-11 novembre 2015
Severe sepsis and septic shock presentation and
mortality
SIMIT 2015, Catania 8-11 novembre 2015
SIMIT 2015, Catania 8-11 novembre 2015
SIMIT 2015, Catania 8-11 novembre 2015
Limitations
• Retrospective design of the study
We evaluated a relatively large and
population
•homogeneous
It was difficult to control the
analysis of risk factorsof
of
mortality patients
for the variable
severity represents
of ongoing diseasea
elderly
which
growing
population
in
most
• Microbiological data are limited and do not permit
an in-depth analysis
of susceptibility
developed
countries
SIMIT 2015, Catania 8-11 novembre 2015
Conclusions
• The major strength of this multicentre study was to provide
evidence of the higher burden of several host-related risk
factors for candidemia in patients admitted to internal
medicine and specialized medicine wards than in patients in
other wards
• our data highlight that risk factors for candidemia should be
explored in future controlled studies on patients admitted in
medicine wards
SIMIT 2015, Catania 8-11 novembre 2015
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