Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea.
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea.
Int J Infect Dis. 2020 Apr;93:126-132. doi: 10.1016/j.ijid.2020.01.049. Epub 2020 Jan 30.
This study evaluated the incidence, risk factors, and clinical characteristics of complications of candidaemia in adults, with a focus on endophthalmitis, endocarditis, and osteoarticular infections.
All patients ≥18 years old with candidaemia in two Korean tertiary hospitals from 2007 to 2016 were investigated. Complications of candidaemia were defined as the presence of endophthalmitis, endocarditis, or osteoarticular infections documented in patients with candidaemia. The clinical characteristics and risk factors for candidaemia with complications were analysed in the patients who underwent ophthalmological examinations.
Of 765 adult patients with candidaemia, 34 (4.4%) met the definition of complications, including endophthalmitis in 29 (3.8%), endocarditis in 4 (0.5%), and osteoarticular infections in 3 (0.4%). Of the 225 patients who underwent ophthalmological examinations, 29 (12.9%) had endophthalmitis. Candida albicans was an independent risk factor for complicated candidaemia (OR, 5.12; 95% CI, 2.17-12.09; P < 0.001). Although the mortality rate was no higher in complicated candidaemia, the duration of antifungal therapy was longer (23.1 ± 17.6 vs. 16.4 ± 10.8 days, P = 0.042), and 13 patients (39.3%) underwent additional procedures or surgery.
Complications of candidaemia occurred in 4.4% of adult patients. C. albicans was an independent risk factor for complicated candidaemia in adults. Complications of candidaemia might need prolonged treatment and additional procedures or surgery. Therefore, careful evaluation and active treatment of candidaemia with complications should be encouraged.
本研究评估了成人念珠菌血症并发症的发生率、危险因素和临床特征，重点关注眼内炎、心内膜炎和骨关节炎感染。
对 2007 年至 2016 年期间韩国两家三级医院的 765 例≥18 岁成人念珠菌血症患者进行了调查。念珠菌血症并发症的定义为在念珠菌血症患者中发现眼内炎、心内膜炎或骨关节炎感染。对接受眼科检查的患者进行了念珠菌血症合并症的临床特征和危险因素分析。
765 例成人念珠菌血症患者中，34 例（4.4%）符合并发症定义，其中 29 例（3.8%）为眼内炎，4 例（0.5%）为心内膜炎，3 例（0.4%）为骨关节炎感染。在 225 例接受眼科检查的患者中，29 例（12.9%）患有眼内炎。白色念珠菌是念珠菌血症合并症的独立危险因素（OR，5.12；95%CI，2.17-12.09；P＜0.001）。虽然合并念珠菌血症的死亡率没有更高，但抗真菌治疗的时间更长（23.1±17.6 天 vs. 16.4±10.8 天，P=0.042），13 例（39.3%）需要进行额外的治疗或手术。
成人念珠菌血症并发症发生率为 4.4%。白色念珠菌是成人念珠菌血症合并症的独立危险因素。念珠菌血症的并发症可能需要延长治疗和额外的治疗或手术。因此，应鼓励仔细评估和积极治疗念珠菌血症合并症。
