Abstract | BACKGROUND: METHODS: We designed a prospective, observational, single center, population-based study in a SICU. We included all consecutive adult patients (≥18 years old) who had documented IC, either on admission or during their stay, between January 2012 and December 2013. RESULTS: There were a total of 22 episodes of IC in the 1149 patients admitted during the 24-month study. The overall IC incidence was 19.1 cases per 1000 admissions. Thirteen cases of IC (59.1%) were intra-abdominal candidiasis (IAC) and 9 (40.9%) were candidemias. All cases of IAC were patients with secondary peritonitis and severe sepsis or septic shock. The overall crude mortality rate was 13.6%; while, it was 33% in patients with candidemia. All patients with IAC survived, including one patient with concomitant candidemia. The most common species causing IC was Candida albicans (13; 59.1%) followed by Candida parapsilosis (5; 22.7%), and Candida glabrata (2; 9.1%). There was also one case each (4.5%) of Candida krusei and Candida tropicalis. Thus, the ratio of non-C. albicans (9) to C. albicans (13) was 1:1.4. There was resistance to fluconazole and itraconazole in 13.6% of cases. Resistance to other antifungals was uncommon. CONCLUSIONS: Candida parapsilosis was the second most common species after C. albicans, indicating the high prevalence of non-C. albicans species in the SICU. Resistance to azoles, particularly fluconazole, should be considered when starting an empirical treatment. Although IAC is a very frequent form of IC in critically ill surgical patients, prompt antifungal therapy and adequate source control appears to lead to a good outcome. However, our results are closely related to our ICU and any generalization must be taken with caution. Therefore, further investigations are needed.
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Authors | Gerardo Aguilar, Carlos Delgado, Isabel Corrales, Ana Izquierdo, Estefanía Gracia, Tania Moreno, Esther Romero, Carlos Ferrando, José A Carbonell, Rafael Borrás, David Navarro, F Javier Belda |
Journal | BMC research notes
(BMC Res Notes)
Vol. 8
Pg. 491
(Sep 29 2015)
ISSN: 1756-0500 [Electronic] England |
PMID | 26415526
(Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Abdomen
(microbiology, pathology)
- Aged
- Antifungal Agents
(pharmacology)
- Candida
(drug effects, isolation & purification)
- Candidiasis, Invasive
(epidemiology, microbiology)
- Drug Resistance, Fungal
(drug effects)
- Female
- Humans
- Intensive Care Units
(statistics & numerical data)
- Male
- Microbial Sensitivity Tests
- Middle Aged
- Spain
(epidemiology)
- Surgery Department, Hospital
(statistics & numerical data)
- Surgical Wound Infection
(microbiology)
- Treatment Outcome
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