1. Universidad Militar Nueva Granada, School of Medicine
PREVALENCE OF RISK FACTORS FOR INVASIVE CANDIDIASIS IN IMMUNOCOMPETENT ADULT INTENSIVE CARE UNIT PATIENTS, BOGOTA-COLOMBIA
SALINAS O. (2), MAHECHA J. (2), PEREZ J. (1,3), PESCADOR A. (1,5), BASTIDAS A. (2), GONZALEZ M. (1,5), ESCOBAR J. (1,4), GOMEZ C. (1,3), BRAVO J. (1,2)
1 Grupo de Investigación en Enfermedades Infecciosas - Hospital Militar Central “GREINMIL”
Universidad Militar Nueva Granada, School of Medicine
Department of Internal Medicine2, Infectious Diseases3, Epidemiology4 and Laboratory5.
Bogotá, Colombia
INTRODUCTION
Infection by Candida spp is the fourth cause of nosocomial infection in ICU with mortality rate near to 40 %. Candida Score and Ostrosky rules allow to anticipate the candidemia, for the late diagnosis using actual available microbiology tests. However, the prevalence of risk factors and the characteristics of the microorganism vary between the different medical records.
METHODOLOGY
A cross-sectional analytical study was performed in immunocompetent adult ICU patients. Prevalence of risk factors for invasive candidiasis at Hospital Militar Central between 2010 and The study was approved by medical ethic committee.
RESULTS
COPD: Chronic Obstructive Pulmonary Disease
Isolates distribution
We identified 178 positive blood and peritoneal fluid cultures for Candida spp, 40 of them were excluded. 64,4% were male, median age was 53 years old. Identified comorbidities and risk factors were central venous catheter (90%), invasive mechanical ventilation (74%), total parenteral nutrition (59%), End-stage renal disease on dialysis (38%), Diabetes Mellitus (26%) and COPD (25%).
Candida albicans, C. parapsilopsis and C. tropicalis were isolated in blood cultures in 37%, 33% and 23%, respectively. Candida score was calculated for 36% of the patients, 67.8% of them with score 3. Ostrosky rules were positive on 56%. Fluconazole resistance in blood isolates was 4%.
CONCLUSIONS
In our study, the most prevalent risk factor were use of central venous catheter, invasive mechanical ventilation and total parenteral nutrition. Cultures instead KOH test must be done for the colonization index. Nowadays prediction scales are incomplete, with low sensivity for early invasive candidiasis diagnosis.
Los autores no tienen conflicto de intereses para declarar.
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3. León C, et al. A bedside scoring system (“Cándida score”) for early antifungal treatment in nonneutropenic critically ill patients with Candida colonization. Crit Care Med. 2006;34(3):