Bir Üniversite Hastanesinde Kandidemi Olgularının Retrospektif Olarak Değerlendirilmesi

Amaç: Kandidemi, hastane infeksiyonları arasında sıklığı artan; Candida albicans ve non- albicans Candida (NAC) türleri ile gelişen ciddi bir infeksiyondur. Çalışmamızda, yatan hastalarda kandidemi etkenlerine göre klinik ve laboratuvar verilerin irdelenmesi amaçlanmıştır. Gereç ve Yöntem: Hastanemiz laboratuvarında 2017-2019 yıllarında kan kültüründe maya üremesi olan 31 hasta retrospektik olarak incelendi. Hastaların klinik ve laboratuvar verileri incelendi. C.albicans ve NAC türü maya üremesine göre gruplar arasında farklılıklar değerlendirildi. Bulgular: Olguların %58’i kadın ve % 52’sinde malignite saptandı. %48’inde kandidemi etkeni olarak C.albicans saptanırken, %52’sinde NAC üredi. Santral venöz kateter varlığı, total parenteral nutrisyon varlığı ve erken üreme oranı (

Retrospective Evaluation of Candidemia Cases in a University Hospital Evaluation of Candidemia Cases

Purpose: Candidemia, a serious infection caused by Candida albicans and non-albicans Candida (NAC) species, is an increasing cause of nosocomial infections, We aimed to determine clinical and laboratory features for the patients with candidemia in this study. Materials and Methods: 31 patients with candidemia, between 2017-2019 were retrospectively analyzed. Clinical and laboratory data of the patients were examined. Differences between groups were evaluated according to the growth of C.albicans and NAC. Results: 58% of the cases were women and 52% of the cases had malignancy. C.albicans was detected as the cause of candidemia in 48%, while NAC was produced in 52%. Central venous catheter and total parenteral nutrition and early growth rate (

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  • 1. Lepak A, Andes D. Fungal sepsis: optimizing antifungal therapy in the critical care setting. Crit Care Clin. 2011 Jan;27(1):123-47. doi:10.1016/j.ccc.2010.11.001. PMID: 21144990.
  • 2. Neofytos D, Lu K, Hatfield-Seung A, et al. Epidemiology, outcomes, and risk factors of invasive fungal infections in adult patients with acute myelogenous leukemia after induction chemotherapy. Diagn Microbiol Infect Dis. 2013 Feb;75(2):144-9. doi: 10.1016/j. diagmicrobio.2012.10.001. Epub 2012 Nov 8. PMID: 23142166; PMCID: PMC39860433.
  • 3. Antinori S, Milazzo L, Sollima S, Galli M, Corbellino M. Candidemia and invasive candidiasis in adults: A narrative review. Eur J Intern Med. 2016 Oct;34:21-28. doi: 10.1016/j. ejim.2016.06.029. Epub 2016 Jul 7. PMID: 27394927.
  • 4. Guinea J. Global trends in the distribution of Candida species causing candidemia. Clin Microbiol Infect. 2014 Jun;20 Suppl 6:5-10. doi: 10.1111/1469-0691.12539. Epub 2014 Mar 6. PMID: 24506442.
  • 5. Salehi M, Ghomi Z, Mirshahi R, Dehghan Manshadi SA, Rezahosseini O. Epidemiology and Outcomes of Candidemia in a Referral Center in Tehran. Caspian J Intern Med. 2019 Winter;10(1):73-79. doi: 10.22088/cjim.10.1.73. PMID: 30858944; PMCID: PMC6386322.
  • 6. Kilic AU, Basaga SM, Cevahir F, Cakir O, Doganay M, Alp E. Risk prediction for candidemia in surgical intensive care unit patients. North Clin Istanb. 2020 Jun 1;7(4):348-353. doi: 10.14744/ nci.2020.27136. PMID: 33043259; PMCID: PMC7521091.
  • 7. Haciseyitoğlu D, Çağ Y. An outbreak of candidemia due to Candida parapsilosis in an adult intensive care unit. Infez Med. 2019 Dec 1;27(4):403-409. PMID: 31846990.
  • 8. Horn DL, Neofytos D, Anaissie EJ, et al. Epidemiology and outcomes of candidemia in 2019 patients: data from the prospective antifungal therapy alliance registry. Clin Infect Dis. 2009 Jun 15;48(12):1695-703. doi: 10.1086/599039. PMID: 19441981.
  • 9. Çiçek B, Yılmaz H, Mutlu Yılmaz E, Esen Ş, Birinci A. Candida epidemiyolojisindeki değişikliklerin araştırılması [Investigation of the changes in Candida epidemiology]. Mikrobiyol Bul. 2015 Jul;49(3):423-31. Turkish. doi: 10.5578/mb.9647. PMID: 26313283.
  • 10. Medeiros MAP, Melo APV, Bento AO, et al. Epidemiology and prognostic factors of nosocomial candidemia in Northeast Brazil: A six-year retrospective study. PLoS One. 2019 Aug 22;14(8):e0221033. doi: 10.1371/journal. pone.0221033. PMID: 31437188; PMCID: PMC6705852.
  • 11. Israel S, Amit S, Israel A, Livneh A, Nir-Paz R, Korem M. The Epidemiology and Susceptibility of Candidemia in Jerusalem, Israel. Front Cell Infect Microbiol. 2019 Oct 11;9:352. doi: 10.3389/ fcimb.2019.00352. PMID: 31681629; PMCID: PMC6801307.
  • 12. Kim EJ, Lee E, Kwak YG, et al. Trends in the Epidemiology of Candidemia in Intensive Care Units From 2006 to 2017: Results From the Korean National Healthcare-Associated Infections Surveillance System. Front Med (Lausanne). 2020 Dec 17;7:606976. doi: 10.3389/ fmed.2020.606976. PMID: 33392229; PMCID: PMC7773785.
  • 13. Poissy J, Damonti L, Bignon A, et al. Risk factors for candidemia: a prospective matched case- control study. Crit Care. 2020 Mar 18;24(1):109. doi: 10.1186/s13054-020-2766-1. PMID: 32188500; PMCID: PMC7081522.
  • 14. Chen S, Slavin M, Nguyen Q, et al. Active surveillance for candidemia, Australia. Emerg Infect Dis. 2006 Oct;12(10):1508-16. doi: 10.3201/eid1210.060389. PMID: 17176564; PMCID: PMC3290948.
  • 15. Alves PGV, Melo SGO, Bessa MAS, et al. Risk factors associated with mortality among patients who had candidemia in a university hospital. Rev Soc Bras Med Trop. 2020 Jun 22;53:e20190206. doi: 10.1590/0037-8682-0206-2019. PMID: 32578699; PMCID: PMC7310371.
  • 16. Garey KW, Rege M, Pai MP, et al. Time to initiation of fluconazole therapy impacts mortality in patients with candidemia: a multi-institutional study. Clin Infect Dis. 2006 Jul 1;43(1):25-31. doi: 10.1086/504810. Epub 2006 May 16. PMID: 16758414.
  • 17. Muñoz P, Bernaldo de Quirós JC, Berenguer J, et al. Impact of the BACTEC NR system in detecting Candida fungemia. J Clin Microbiol. 1990 Mar;28(3):639-41. doi: 10.1128/ JCM.28.3.639-641.1990. PMID: 2324285; PMCID: PMC269685.
  • 18. Bassetti M, Russo A, Righi E, et al. Role of procalcitonin in bacteremic patients and its potential use in predicting infection etiology. Expert Rev Anti Infect Ther. 2019 Feb;17(2):99- 105. doi: 10.1080/14787210.2019.1562335. Epub 2018 Dec 30. PMID: 30582713.
  • 19. Raineri SM, Cortegiani A, Vitale F, Iozzo P, Giarratano A. Procalcitonin for the diagnosis of invasive candidiasis: what is the evidence? J Intensive Care. 2017 Sep 25;5:58. doi: 10.1186/ s40560-017-0252-x. PMID: 28975031; PMCID: PMC5613326.
  • 20. Martini A, Gottin L, Menestrina N, Schweiger V, Simion D, Vincent JL. Procalcitonin levels in surgical patients at risk of candidemia. J Infect. 2010 Jun;60(6):425-30. doi: 10.1016/j. jinf.2010.03.003. Epub 2010 Mar 10. PMID: 20226210.
  • 21. Cortegiani A, Misseri G, Ippolito M, et al. Procalcitonin levels in candidemia versus bacteremia: a systematic review. Crit Care. 2019 May 28;23(1):190. doi: 10.1186/s13054- 019-2481-y. Erratum in: Crit Care. 2019 Oct 11;23(1):322. PMID: 31138262; PMCID: PMC6537202.
  • 22. Pieralli F, Corbo L, Torrigiani A et al. Usefulness of procalcitonin in differentiating Candida and bacterial blood stream infections in critically ill septic patients outside the intensive care unit. Intern Emerg Med. 2017 Aug;12(5):629-635. doi: 10.1007/s11739-017-1627-7. Epub 2017 Feb 4. PMID: 28161884.