Independent risk factors for mortality in critically ill patients with candidemia on Italian Internal Medicine Wards |
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| Authors: | Francesco Sbrana Emanuela Sozio Matteo Bassetti Andrea Ripoli Filippo Pieralli Anna Maria Azzini Alessandro Morettini Carlo Nozzoli Maria Merelli Sebastiano Rizzardo Giacomo Bertolino Davide Carrara Claudio Scarparo Ercole Concia Francesco Menichetti Carlo Tascini |
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| Institution: | 1.Fondazione Toscana Gabriele Monasterio,Pisa,Italy;2.North-West District, Tuscany HealthCare, Spedali Riuniti Livorno, Emergency Department,Leghorn,Italy;3.Infectious Diseases Division,Santa Maria Misericordia University Hospital,Udine,Italy;4.Intermediate Care Unit,Azienda Ospedaliera Universitaria Careggi,Florence,Italy;5.Infectious Disease Unit,Azienda Ospedaliera Universitaria Integrata di Verona,Verona,Italy;6.Internal Medicine Unit,Azienda Ospedaliera Universitaria Careggi,Florence,Italy;7.Pharmaceutical Department,Azienda Ospedaliera Universitaria Pisana,Pisa,Italy;8.U.O.C. Medicina Generale, Ospedale Versilia,Azienda U.S.L. Toscana Nord Ovest,Viareggio,Italy;9.Infectious Diseases Clinic, Nuovo Santa Chiara University Hospital,Azienda Ospedaliera Universitaria Pisana,Pisa,Italy;10.First Division of Infectious Diseases, Cotugno Hospital,Azienda Ospedaliera dei Colli,Naples,Italy |
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| Abstract: | Candida is an increasing cause of bloodstream infection and is associated with significant morbidity and mortality. The aim of our study is to analyze risk factors for short-term mortality in patients with bloodstream Candida spp. infections admitted to Internal Medicine Wards (IMWs). This was a retrospective case–control study between January 2012 and December 2014 from four University Hospitals in Italy, where patients with candidemia dying within 30 days from diagnosis were matched to control cases with candidemia who survived in the same period of time. Two-hundred and fifty cases of candidemia were registered during the 36 months of enrollment. Among these, 112 patients died (45%) within 30 days from the first blood culture’s positivity for Candida spp. At multivariate analysis, septic shock odds ratio (95% CI) = 2.919 (1.62–5.35), p < 0.001] and concomitant chronic kidney failure odds ratio (95% CI) = 2.296 (1.07–5.12), p = 0.036] were independent predictors of mortality. Low-dose chronic steroid therapy was protective odds ratio (95% CI) = 0.461 (0.25–0.83), p = 0.011). |
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