Factores de riesgo asociados a candidemia en pacientes críticos no neutropénicos en Colombia

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Ortíz Ruiz, G..pdf (547.64 KB)

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2016

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Medicina Intensiva, 0210-5691, Vol 40, Nro 3, 2016, p. 139-144

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Elsevier

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https://hdl.handle.net/20.500.12495/3623

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https://www-clinicalkey-es.ezproxy.unbosque.edu.co/#!/content/playContent/1-s2.0-S0210569115001941?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0210569115001941%3Fshowall%3Dtrue&referrer=https:%2F%2Fresolver.ebscohost.com%2Fopenurl%3Fsid%3DEBSCO%253aedselp%26genre%3Darticle%26issn%3D02105691%26ISBN%3D%26volume%3D40%26issue%3D3%26date%3D20160401%26spage%3D139%26pages%3D139-144%26title%3DMedicina%2Bintensiva%26atitle%3DFactores%2Bde%2Briesgo%2Basociados%2Ba%2Bcandidemia%2Ben%2Bpacientes%2Bcr%25c3%25adticos%2Bno%2Bneutrop%25c3%25a9nicos%2Ben%2BColombia%26aulast%3DOrt%25c3%25adz%2BRuiz%252c%2BG.%26id%3DDOI%253a10.1016%252fj.medin.2015.08.001%26site%3Dftf-live%26SToken%3DA0ICm4c692cl8XukVJlxpxS1iZIFHm40FMYEFosFqvXWGUeG0jFKCYVSEEIHVxZEgYXok2kq9ioSnSz12gQilztSWmPTJJNJtAzNpu3nUo2L5LOsLUFcBAHGRgCFtnprHnnsZ8_hOL_f_T9La7U4Ni2VEIXHIhcAX7lAiD_YT3qNyu1siBbQ24bKiocHXeha6KbxIaNRUF971INn5H69394GsksyGQTwzG4AsPSgmveCbN_sbtubaGR7mnz0wK4SgYbmK18Ba5aaOtaj6HwUy09ujHo

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Objetivos Determinar los factores de riesgo asociados a candidemia en pacientes críticos de 7 unidades de cuidados intensivos de Colombia. Materiales y métodos Estudio de casos y controles pareado, multicéntrico, retrospectivo, en 7 unidades de cuidados intensivos de 3 hospitales universitarios. Se tomaron datos de duración de la estancia hospitalaria global (incluyendo salas generales) y en la unidad de cuidados intensivos. Resultados Se incluyeron 243 participantes (81 casos y 162 controles) entre enero de 2008 y diciembre de 2012. Se aislaron en orden de frecuencia C. albicans, C. tropicalis y C. parapsilosis . Los principales factores de riesgo identificados fueron: tiempo de estancia hospitalaria global > 25 días (OR 5,33; IC 95% 2,6-10,9), uso de meropenem (OR 3,75; IC 95% 1,86-7,5), cirugía abdominal (OR 2,9; IC 95% 1,39-6,06) y hemodiálisis (OR 3,35; IC 95% 1,5-7,7). No se encontraron diferencias en mortalidad entre los grupos de pacientes con candidemia y el grupo control (39,5 frente a 36,5%; p = 0,66). Conclusiones Se identificaron como factores de riesgo para candidemia en Colombia la larga estancia hospitalaria, la cirugía abdominal, el uso de meropenem y la hemodiálisis.

Descripción

Abstract

Objectives Due to the increase in isolation of Candida spp. in critically ill patients, and the high mortality and economic costs which this infection entails, a study was made of the risk factors associated to candidemia in critically ill patients from 7 intensive care units in Colombia. Materials and methods A multicenter matched case-control study was conducted in 7 intensive care units of 3 university hospitals. Data on overall length of hospital stay (including both general wards and the intensive care unit) were recorded. Results A total of 243 subjects (81 cases and 162 controls) between January 2008 and December 2012 were included. In order of frequency, C. albicans , C. tropicalis and C. parapsilosis were isolated. The main identified risk factors were: overall length of hospital stay > 25 days (OR 5.33, 95% CI 2.6-10.9), use of meropenem (OR 3.75, 95% CI 1.86-7.5), abdominal surgery (OR 2.9, 95% CI 1.39-6.06) and hemodialysis (OR 3.35, 95% CI 1.5-7.7). No differences in mortality between patients with candidemia and controls were found (39.5 vs. 36.5%, respectively, P = .66) were found. Conclusions In Colombia, a long hospital stay, abdominal surgery, the use of meropenem and hemodialysis were identified as risk factors for candidemia.

Palabras clave

Candida, Factores de riesgo, Mortalidad, Cuidado intensivo, Candidiasis invasiva

Keywords

Candida, Risk factors, Mortality, Intensive care, Invasive candidiasis

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