Evaluation of risk factors for candida colonization and infection in non-neutropenic intensive care patients

Abstract

Objective: In patients who are followed in intensive care unit (ICU), colonization and/or invasive infections with Candida species occur in the presence of various risk factors. Difficulties in diagnosis cause delays in antifungal therapy and this is related with increased mortality. Material and Methods: In this retrospective case control study, patients were classified as colonized, infected and control group and independent risk factors for Candida colonization and invasive Candida infections were evaluated. Patients followed in Anesthesiology-Reanimation and Medical ICUs of Ankara University Ibn-i Sina Hospital between June 2013 and June 2015 were retrospectively screened. A total of 225 patients, who stayed more than 48 hours in ICU, who were non-neutropenic and above 18 years were included. All demographics and risk factors were recorded. Results: Central venous catheter and sepsis/septic shock were found to be the independent risk factors for Candida colonization; presence of central venous catheter, total parenteral nutrition (TPN) use and sepsis/septic shock were found to be the independent risk factors for Candida infection. Conclusion: In high risk patients, early and appropriate antifungal therapy decreases mortality. Therefore, for doctors, who works with intensive care, identifying high risk patients for invasive Candida infections is important. Presence of central venous catheter, sepsis/septic shock and TPN use should be considered in intensive care patients.