Le candidemie in una coorte di 686 pazienti anziani del Triveneto: analisi dei fattori di rischio per candidemia e mortalità C. Rosin, A. Azzini, M. Merelli,

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Presentation transcript:

Le candidemie in una coorte di 686 pazienti anziani del Triveneto: analisi dei fattori di rischio per candidemia e mortalità C. Rosin, A. Azzini, M. Merelli, S. Cavinato, P. Brugnaro, C. Vedovelli, C. Maurel, J. Monticelli, M. Busetti, P.Mian, A.M. Cattelan, E. Raise, F. Ansaldi*, M. Bassetti, E. Concia, R. Luzzati e Triveneto SIMIT-group Malattie Infettive degli Ospedali di Trieste, Verona, Udine, Padova, Venezia-Mestre, Bolzano; *Ist. di Igiene, Università di Genova. SIMIT 2015, Catania 8-11 novembre 2015 Dott.ssa Chiara Rosin SC. Malattie Infettive (Trieste)

Introduction 40% to 60% of candidemia episodes were found in patients admitted to internal medicine wards according to some studies Critically ill individuals in intensive care units (ICUs) remained the leading target population representing 41-48% of patients with candidemia in other studies Although candidemia is more frequent among elderly patients, available data on this growing patient population are still limited SIMIT 2015, Catania 8-11 novembre 2015

Objectives Aim of this study was to compare risk factors for nosocomial candidemia, severity of sepsis, and outcome between patients admitted to internal medicine and specialized medical wards and those to surgery and intensive care units (ICUs) SIMIT 2015, Catania 8-11 novembre 2015

Methods This multicentre retrospective study includes patients affected by nosocomial candidemia admitted to six public referral hospitals in 6 cities located in northeastern Italy between January 2011 and December 2013 Antifungal treatment was considered adequate when the infecting Candida strain was ultimately shown to be susceptible and the dosage of antifungals used was adequate within the first 48 h from the onset of candidemia Crude mortality rate was calculate at 30 days from the diagnosis of candidemia differentiating patients died with and without fungemia SIMIT 2015, Catania 8-11 novembre 2015

Severe sepsis and septic shock presentation and mortality SIMIT 2015, Catania 8-11 novembre 2015

Limitations Retrospective design of the study It was difficult to control the analysis of risk factors of mortality for the variable severity of ongoing disease Microbiological data are limited and do not permit an in-depth analysis of susceptibility We evaluated a relatively large and homogeneous population of elderly patients which represents a growing population in most developed countries SIMIT 2015, Catania 8-11 novembre 2015

Conclusions The major strength of this multicentre study was to provide evidence of the higher burden of several host-related risk factors for candidemia in patients admitted to internal medicine and specialized medicine wards than in patients in other wards our data highlight that risk factors for candidemia should be explored in future controlled studies on patients admitted in medicine wards SIMIT 2015, Catania 8-11 novembre 2015

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