TY - JOUR
T1 - Risk factors for candidal bloodstream infections in surgical intensive care unit patients
T2 - The NEMIS prospective multicenter study
AU - Blumberg, Henry M.
AU - Jarvis, William R.
AU - Soucie, J. Michael
AU - Edwards, Jack E.
AU - Patterson, Jan E.
AU - Pfaller, Michael A.
AU - Rangel-Frausto, M. Sigfrido
AU - Rinaldi, Michael G.
AU - Saiman, Lisa
AU - Wiblin, R. Todd
AU - Wenzel, Richard P.
N1 - Funding Information:
Grant support: This study was supported by an educational grant from Pfizer, Inc.
PY - 2001/7/15
Y1 - 2001/7/15
N2 - To assess risk factors for development of candidal blood stream infections (CBSIs), a prospective cohort study was performed at 6 sites that involved all patients admitted to the surgical intensive care unit (SICU) for >48 h over a 2-year period. Among 4276 such patients, 42 CBSIs occurred (9.82 CBSIs per 1000 admissions). The overall incidence was 0.98 CBSIs per 1000 patient days and 1.42 per 1000 SICU days with a central venous catheter in place. In multivariate analysis, factors independently associated with increased risk of CBSI included prior surgery (relative risk [RR], 7.3), acute renal failure (RR, 4.2), receipt of parenteral nutrition (RR, 3.6), and, for patients who had undergone surgery, presence of a triple lumen catheter (RR, 5.4). Receipt of an antifungal agent was associated with decreased risk (RR, 0.3). Prospective clinical studies are needed to identify which antifungal agents are most protective and which high-risk patients will benefit from antifungal prophylaxis.
AB - To assess risk factors for development of candidal blood stream infections (CBSIs), a prospective cohort study was performed at 6 sites that involved all patients admitted to the surgical intensive care unit (SICU) for >48 h over a 2-year period. Among 4276 such patients, 42 CBSIs occurred (9.82 CBSIs per 1000 admissions). The overall incidence was 0.98 CBSIs per 1000 patient days and 1.42 per 1000 SICU days with a central venous catheter in place. In multivariate analysis, factors independently associated with increased risk of CBSI included prior surgery (relative risk [RR], 7.3), acute renal failure (RR, 4.2), receipt of parenteral nutrition (RR, 3.6), and, for patients who had undergone surgery, presence of a triple lumen catheter (RR, 5.4). Receipt of an antifungal agent was associated with decreased risk (RR, 0.3). Prospective clinical studies are needed to identify which antifungal agents are most protective and which high-risk patients will benefit from antifungal prophylaxis.
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U2 - 10.1086/321811
DO - 10.1086/321811
M3 - Article
C2 - 11418877
AN - SCOPUS:0035879504
SN - 1058-4838
VL - 33
SP - 177
EP - 186
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 2
ER -