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NASHVILLE, TENN. — Candida infections are associated with a significant increase in hospital length of stay and a twofold increase in mortality in patients who require mechanical ventilation during a stay in the intensive care unit.
“Whether Candida species colonization of the respiratory tract secretions is a marker of disease severity or actually contributes to prolonged mechanical ventilation, ICU and hospital stay, and mortality requires further evaluation,” Dr. Marc M. Perrault said in a poster presented at the annual congress of the Society of Critical Care Medicine.
“The role of antifungal therapy in these patients also remains to be determined,” said Dr. Perrault, a pharmacist at the McGill University Health Center in Montreal.
He and his colleagues retrospectively analyzed data collected during a large clinical trial that randomized 740 critically ill, mechanically ventilated patients to bronchoscopy or endotracheal aspiration, followed by randomization to treatment with meropenem alone or in combination with ciprofloxacin.
Of the 274 patients who had negative bacterial cultures on enrollment, 64 subsequently tested positive for a Candida species. The mean age was 60 years; the mean APACHE II score was 20. At baseline, three characteristics were significantly different between the groups: antibiotic use in the past 3 days, respiratory rate, and white blood cell count. The final analysis controlled for these risk factors.
In the univariate analysis, 14-day mortality was not significantly different between the groups. But at 28 days, patients with Candida infections were more than twice as likely to have died—31% vs. 15%, a significant difference. ICU mortality was also significantly higher in the Candida group (29% vs. 14%; odds ratio, 2.65). Cumulative in-hospital mortality was more than twice as common in Candida-infected patients (43% vs. 20%).
When the researchers controlled for the risk factors, patients with Candida infections were still more than twice as likely to die in the hospital as those without the infections.
Intravenous antifungal treatment was given to 15 patients with Candida (22%) and 26 without (13%). No treated patient developed candidemia, but the report did not state how many untreated patients developed that complication.
NASHVILLE, TENN. — Candida infections are associated with a significant increase in hospital length of stay and a twofold increase in mortality in patients who require mechanical ventilation during a stay in the intensive care unit.
“Whether Candida species colonization of the respiratory tract secretions is a marker of disease severity or actually contributes to prolonged mechanical ventilation, ICU and hospital stay, and mortality requires further evaluation,” Dr. Marc M. Perrault said in a poster presented at the annual congress of the Society of Critical Care Medicine.
“The role of antifungal therapy in these patients also remains to be determined,” said Dr. Perrault, a pharmacist at the McGill University Health Center in Montreal.
He and his colleagues retrospectively analyzed data collected during a large clinical trial that randomized 740 critically ill, mechanically ventilated patients to bronchoscopy or endotracheal aspiration, followed by randomization to treatment with meropenem alone or in combination with ciprofloxacin.
Of the 274 patients who had negative bacterial cultures on enrollment, 64 subsequently tested positive for a Candida species. The mean age was 60 years; the mean APACHE II score was 20. At baseline, three characteristics were significantly different between the groups: antibiotic use in the past 3 days, respiratory rate, and white blood cell count. The final analysis controlled for these risk factors.
In the univariate analysis, 14-day mortality was not significantly different between the groups. But at 28 days, patients with Candida infections were more than twice as likely to have died—31% vs. 15%, a significant difference. ICU mortality was also significantly higher in the Candida group (29% vs. 14%; odds ratio, 2.65). Cumulative in-hospital mortality was more than twice as common in Candida-infected patients (43% vs. 20%).
When the researchers controlled for the risk factors, patients with Candida infections were still more than twice as likely to die in the hospital as those without the infections.
Intravenous antifungal treatment was given to 15 patients with Candida (22%) and 26 without (13%). No treated patient developed candidemia, but the report did not state how many untreated patients developed that complication.
NASHVILLE, TENN. — Candida infections are associated with a significant increase in hospital length of stay and a twofold increase in mortality in patients who require mechanical ventilation during a stay in the intensive care unit.
“Whether Candida species colonization of the respiratory tract secretions is a marker of disease severity or actually contributes to prolonged mechanical ventilation, ICU and hospital stay, and mortality requires further evaluation,” Dr. Marc M. Perrault said in a poster presented at the annual congress of the Society of Critical Care Medicine.
“The role of antifungal therapy in these patients also remains to be determined,” said Dr. Perrault, a pharmacist at the McGill University Health Center in Montreal.
He and his colleagues retrospectively analyzed data collected during a large clinical trial that randomized 740 critically ill, mechanically ventilated patients to bronchoscopy or endotracheal aspiration, followed by randomization to treatment with meropenem alone or in combination with ciprofloxacin.
Of the 274 patients who had negative bacterial cultures on enrollment, 64 subsequently tested positive for a Candida species. The mean age was 60 years; the mean APACHE II score was 20. At baseline, three characteristics were significantly different between the groups: antibiotic use in the past 3 days, respiratory rate, and white blood cell count. The final analysis controlled for these risk factors.
In the univariate analysis, 14-day mortality was not significantly different between the groups. But at 28 days, patients with Candida infections were more than twice as likely to have died—31% vs. 15%, a significant difference. ICU mortality was also significantly higher in the Candida group (29% vs. 14%; odds ratio, 2.65). Cumulative in-hospital mortality was more than twice as common in Candida-infected patients (43% vs. 20%).
When the researchers controlled for the risk factors, patients with Candida infections were still more than twice as likely to die in the hospital as those without the infections.
Intravenous antifungal treatment was given to 15 patients with Candida (22%) and 26 without (13%). No treated patient developed candidemia, but the report did not state how many untreated patients developed that complication.