Risk Factors for Mortality in Colombian Patients with Candidemia
The aim of the study was to describe the microbiology and susceptibility profile of candidemia and to identify the risk factors associated with mortality in Colombia. A cohort of patients was followed for 30 days during 2008 to 2010. Microbiological identification and susceptibility assessments were...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-05-01
|
| Series: | Journal of Fungi |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2309-608X/7/6/442 |
| _version_ | 1797531798556639232 |
|---|---|
| author | Jorge Alberto Cortés Anita María Montañez Ana María Carreño-Gutiérrez Patricia Reyes Carlos Hernando Gómez Angela Pescador Beatriz Ariza Fernando Rosso |
| author_facet | Jorge Alberto Cortés Anita María Montañez Ana María Carreño-Gutiérrez Patricia Reyes Carlos Hernando Gómez Angela Pescador Beatriz Ariza Fernando Rosso |
| author_sort | Jorge Alberto Cortés |
| collection | DOAJ |
| description | The aim of the study was to describe the microbiology and susceptibility profile of candidemia and to identify the risk factors associated with mortality in Colombia. A cohort of patients was followed for 30 days during 2008 to 2010. Microbiological identification and susceptibility assessments were performed in a reference centre. Demographic, clinical and treatment variables were evaluated for their associations with mortality. A parametric survival regression analysis was used to identify the risk factors associated with mortality. A total of 109 patients with candidemia in four hospitals in Colombia were identified, with a median age of 30 years old. <i>C. parapsilosis</i> was the most frequently identified microorganism (38.5%); the susceptibility of all isolates was high to fluconazole and anidulafungin, except for <i>C. glabrata</i> isolates. The overall mortality was 35.7%, and the risk factors associated with mortality included lack of antifungal treatment (HR 5.5, 95% CI 3.6–11.4), cancer (HR 3.9, 95% CI 2.3–8.0), diabetes (HR 2.5, 95% CI 1.03–6.4), and age (HR 1.13 per every 10 years, 95% CI 1.02–1.24). Catheter removal was associated with a low mortality rate (HR 0.06, 95% CI 0.00–0.49). Prompt antifungal treatment, better glycemic control and catheter removal should be prioritized in the management of candidemia. |
| first_indexed | 2024-03-10T10:49:51Z |
| format | Article |
| id | doaj.art-79e4332814054964bc5020a9b04c895f |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-10T10:49:51Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-79e4332814054964bc5020a9b04c895f2023-11-21T22:20:36ZengMDPI AGJournal of Fungi2309-608X2021-05-017644210.3390/jof7060442Risk Factors for Mortality in Colombian Patients with CandidemiaJorge Alberto Cortés0Anita María Montañez1Ana María Carreño-Gutiérrez2Patricia Reyes3Carlos Hernando Gómez4Angela Pescador5Beatriz Ariza6Fernando Rosso7Department of Internal Medicine, Facultad de Medicina, Hospital Universitario Nacional, Universidad Nacional de Colombia, Bogotá 111321, ColombiaDepartment of Internal Medicine, Facultad de Medicina, Hospital Universitario Nacional, Universidad Nacional de Colombia, Bogotá 111321, ColombiaDepartment of Internal Medicine, Facultad de Medicina, Hospital Universitario Nacional, Universidad Nacional de Colombia, Bogotá 111321, ColombiaDepartment of Infectious Diseases, Clínica Universitaria Colombia, Bogotá 111321, ColombiaHospital Militar Central, Bogotá 111321, ColombiaHospital Militar Central, Bogotá 111321, ColombiaHospital Universitario San Ignacio, Bogotá 111321, ColombiaFundación Valle de Lili, Cali 760026, ColombiaThe aim of the study was to describe the microbiology and susceptibility profile of candidemia and to identify the risk factors associated with mortality in Colombia. A cohort of patients was followed for 30 days during 2008 to 2010. Microbiological identification and susceptibility assessments were performed in a reference centre. Demographic, clinical and treatment variables were evaluated for their associations with mortality. A parametric survival regression analysis was used to identify the risk factors associated with mortality. A total of 109 patients with candidemia in four hospitals in Colombia were identified, with a median age of 30 years old. <i>C. parapsilosis</i> was the most frequently identified microorganism (38.5%); the susceptibility of all isolates was high to fluconazole and anidulafungin, except for <i>C. glabrata</i> isolates. The overall mortality was 35.7%, and the risk factors associated with mortality included lack of antifungal treatment (HR 5.5, 95% CI 3.6–11.4), cancer (HR 3.9, 95% CI 2.3–8.0), diabetes (HR 2.5, 95% CI 1.03–6.4), and age (HR 1.13 per every 10 years, 95% CI 1.02–1.24). Catheter removal was associated with a low mortality rate (HR 0.06, 95% CI 0.00–0.49). Prompt antifungal treatment, better glycemic control and catheter removal should be prioritized in the management of candidemia.https://www.mdpi.com/2309-608X/7/6/442candidemiamycoses<i>Candida</i><i>Candida albicans</i>intensive care unitsmortality |
| spellingShingle | Jorge Alberto Cortés Anita María Montañez Ana María Carreño-Gutiérrez Patricia Reyes Carlos Hernando Gómez Angela Pescador Beatriz Ariza Fernando Rosso Risk Factors for Mortality in Colombian Patients with Candidemia Journal of Fungi candidemia mycoses <i>Candida</i> <i>Candida albicans</i> intensive care units mortality |
| title | Risk Factors for Mortality in Colombian Patients with Candidemia |
| title_full | Risk Factors for Mortality in Colombian Patients with Candidemia |
| title_fullStr | Risk Factors for Mortality in Colombian Patients with Candidemia |
| title_full_unstemmed | Risk Factors for Mortality in Colombian Patients with Candidemia |
| title_short | Risk Factors for Mortality in Colombian Patients with Candidemia |
| title_sort | risk factors for mortality in colombian patients with candidemia |
| topic | candidemia mycoses <i>Candida</i> <i>Candida albicans</i> intensive care units mortality |
| url | https://www.mdpi.com/2309-608X/7/6/442 |
| work_keys_str_mv | AT jorgealbertocortes riskfactorsformortalityincolombianpatientswithcandidemia AT anitamariamontanez riskfactorsformortalityincolombianpatientswithcandidemia AT anamariacarrenogutierrez riskfactorsformortalityincolombianpatientswithcandidemia AT patriciareyes riskfactorsformortalityincolombianpatientswithcandidemia AT carloshernandogomez riskfactorsformortalityincolombianpatientswithcandidemia AT angelapescador riskfactorsformortalityincolombianpatientswithcandidemia AT beatrizariza riskfactorsformortalityincolombianpatientswithcandidemia AT fernandorosso riskfactorsformortalityincolombianpatientswithcandidemia |