Fondazione Toscana Gabriele Monasterio, Via Moruzzi, 1, 56124, Pisa, Italy.
North-West District, Tuscany HealthCare, Spedali Riuniti Livorno, Emergency Department, Leghorn, Italy.
Intern Emerg Med. 2018 Mar;13(2):199-204. doi: 10.1007/s11739-017-1783-9. Epub 2018 Jan 10.
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).
念珠菌是血流感染日益增多的原因，与较高的发病率和死亡率相关。我们的研究目的是分析内科病房（IMWs）中血流念珠菌属感染患者短期死亡率的危险因素。这是一项回顾性病例对照研究，研究时间为 2012 年 1 月至 2014 年 12 月，来自意大利的四家大学医院，在这些医院中，在诊断后 30 天内死于念珠菌血症的患者与同期存活的念珠菌血症对照病例相匹配。在 36 个月的入组期间共登记了 250 例念珠菌血症。其中，112 例患者（45%）在第一次血培养阳性为念珠菌属后 30 天内死亡。多变量分析显示，感染性休克[比值比（95%可信区间）= 2.919（1.62-5.35），p < 0.001]和同时合并慢性肾功能衰竭[比值比（95%可信区间）= 2.296（1.07-5.12），p = 0.036]是死亡率的独立预测因素。低剂量慢性类固醇治疗具有保护作用[比值比（95%可信区间）= 0.461（0.25-0.83），p = 0.011）。
