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카테터 집락화가 없는 지속성 캔디다혈증의 위험인자와 예후

Other Titles
 Risk Factors and Prognosis for Persistent Candidemia without Catheter Colonization 
Authors
 채윤태 ; 정수진 ; 최준용 ; 김준명 ; 송영구 ; 진성준2 한상훈 ; 윤지현 ; 김선빈 ; 백지현2,3 김혜원 ; 구남수 
Citation
 Infection & Chemotherapy (감염과화학요법), Vol.43(4) : 349~354, 2011 
Journal Title
 Infection & Chemotherapy (감염과화학요법) 
ISSN
 1598-8112 
Issue Date
2011
Abstract
BACKGROUND: Candidemia is one of the most common causes of nosocomial bloodstream infection, and increases the morbidity and mortality rate of seriously ill patients. We evaluated the risk factors and outcomes associated with persistent candidemia without catheter colonization (non-catheter related candidemia) and compared them with those of non-persistent candidemia. MATERIALS AND METHODS: A retrospective case-control study was performed to identify risk factors for, and outcomes of, persistent candidemia. All adults who experienced candidemia in a university-affiliated hospital in Korea between January 2005 and December 2009 were included. Patients with catheter colonization were excluded. Persistent candidemia was defined as the occurrence of candidemia in a patient receiving at least 3 days of systemic antifungal agents prior to the second positive blood culture. RESULTS: Of 605 adult patients with candidemia, 104 (17.2%) patients had persistent candidemia and 23 (3.8%) patients were free of catheter colonization. There were no statistically significant differences in baseline characteristics between patients with persistent and non-persistent candidemia. In univariate analysis, less use of metronidazole, glycopeptide, fluoroquinolone, and aminoglycoside, and presence of Candida parapsilosis were significantly associated with persistent candidemia. In multivariate analysis, less use of metronidazole was an independent factor associated with persistent candidemia. The candidemia related mortality was insignificantly (P=0.094) higher in persistent candidemia than non-persistent candidemia. CONCLUSIONS: Persistent candidemia can occur without catheterization. Patterns of antibiotic use could be associated with the occurrence of persistent candidemia, and prognosis of persistent candidemia seems to be worse than non-persistent candidemia. Further studies for persistent candidemia should be performed
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/93872
DOI
10.3947/ic.2011.43.4.349
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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