Candidemia in Older Adults: What Are the Risk Factors for Mortality?
Yıl: 2022 Cilt: 27 Sayı: 2 Sayfa Aralığı: 261 - 267 Metin Dili: İngilizce DOI: 10.5578/flora.20229809 İndeks Tarihi: 10-08-2022
Candidemia in Older Adults: What Are the Risk Factors for Mortality?
Öz: Introduction: As the aging population rises, an increase in Candida infections has also been observed. The aim of this study was to determine the risk factors for early and late mortality due to candidemia in older patients. Materials and Methods: This retrospective observational study included patients aged 65 years and older who were hospitalized in two tertiary care centers and had Candida-positive blood culture between January 1, 2019 and June 1, 2021. Results: Mean age of the 81 patients included in the study was 77.1 ± 7.1 years and 41 (50.6%) were females. The most commonly identified species were Candida albicans and Candida parapsilosis. After candidemia, early (seven-day) mortality occurred in 18 patients (22.2%) and late (30-day) mortality in 42 patients (51.9%). Significant risk factors for early mortality were diabetes mellitus (p= 0.021), hematological malignancy (p= 0.033), late central venous catheter (CVC) removal (p< 0.001), and initiating antifungal therapy more than 48 hours after the first positive blood culture (p< 0.001). Significant risk factors for late mortality were higher comorbidity index (p= 0.018), late CVC removal (p< 0.002), and initiating antifungal therapy after 48 hours (p< 0.001). Late CVC removal was independently associated with a higher risk of early mortality (OR= 21.976, 95% CI= 2.057-234.739, p= 0.011) and higher risk of late mortality (OR= 7.234, 95% CI= 1.820-28.754, p= 0.005). Conclusion: Time to initiation of antifungal therapy and early CVC removal are important factors for improving outcomes in older adults with high mortality risk for candidemia.
Anahtar Kelime: Yaşlılarda Kandidemi: Mortalite Risk Faktörleri Nedir?
Öz: Giriş: Yaşlanan nüfustaki artış ile birlikte kandida infeksiyonlarında da artış gözlenmektedir. Bu çalışmada, yaşlı hastalarda kandidemi için erken ve geç mortalite risk faktörlerinin belirlenmesi amaçlanmıştır. Materyal ve Metod: Bu retrospektif gözlemsel çalışma, 1 Ocak 2019 ile 1 Haziran 2021 tarihleri arasında iki üçüncü basamak merkezde hastaneye yatırılarak izlenen 65 yaş ve üzerinde, kan kültüründe kandida türleri izole tüm kandidemi vakaları ile gerçekleştirilmiştir. Bulgular: Çalışmaya dahil edilen toplam 81 hastanın yaş ortalaması 77.1 ± 7.1 ve 41’i (50.6%) kadındı. En sık tanımlanan kandida türleri Candida albicans ve Candida parapsilosis idi. Kandidemi sonrası hastaların 18’inde (22.2%) erken mortalite (yedi gün) ve 42’sinde (51.9%) geç mortalite (30 gün) saptandı. Erken mortalite için hastalarda anlamlı bulunan risk faktörleri, diabetes mellitus (p= 0.021), hematolojik malignite (p= 0.033), erken santral venöz kateterin (SVK)’i çıkarılmaması (p< 0.001) ve ilk pozitif kan kültüründen 48 saat sonra antifungal tedavi başlanmamasıydı (p< 0.001). Geç mortalite için anlamlı risk faktörleri ise daha yüksek komorbidite indeksi (p= 0.018), erken SVK çıkarılmaması (p< 0.002) ve ilk 48 saatte antifungal tedavi başlanmamasıydı (p< 0.001). Geç SVK çıkarılması erken (OR= 21.976, 95% CI= 2.057-234.739, p= 0.011) ve geç dönem bağımsız olarak (OR= 7.234, CI 95%= 1.820-28.754, p= 0.005) daha yüksek ölüm riski ile ilişkiliydi. Sonuç: Kandidemi için yüksek mortalite riski altında olan yaşlılarda sonuçları iyileştirmek için antifungal tedavinin başlanma süresi ve SVK’nin erken çıkarılması önemli görülmektedir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | tosun p, Karaşahin Ö, Karahan B, Kiziltunc H, Albayrak A (2022). Candidemia in Older Adults: What Are the Risk Factors for Mortality?. , 261 - 267. 10.5578/flora.20229809 |
| Chicago | tosun pinar,Karaşahin Ömer,Karahan Büşra,Kiziltunc Husnu Serdar,Albayrak Ayse Candidemia in Older Adults: What Are the Risk Factors for Mortality?. (2022): 261 - 267. 10.5578/flora.20229809 |
| MLA | tosun pinar,Karaşahin Ömer,Karahan Büşra,Kiziltunc Husnu Serdar,Albayrak Ayse Candidemia in Older Adults: What Are the Risk Factors for Mortality?. , 2022, ss.261 - 267. 10.5578/flora.20229809 |
| AMA | tosun p,Karaşahin Ö,Karahan B,Kiziltunc H,Albayrak A Candidemia in Older Adults: What Are the Risk Factors for Mortality?. . 2022; 261 - 267. 10.5578/flora.20229809 |
| Vancouver | tosun p,Karaşahin Ö,Karahan B,Kiziltunc H,Albayrak A Candidemia in Older Adults: What Are the Risk Factors for Mortality?. . 2022; 261 - 267. 10.5578/flora.20229809 |
| IEEE | tosun p,Karaşahin Ö,Karahan B,Kiziltunc H,Albayrak A "Candidemia in Older Adults: What Are the Risk Factors for Mortality?." , ss.261 - 267, 2022. 10.5578/flora.20229809 |
| ISNAD | tosun, pinar vd. "Candidemia in Older Adults: What Are the Risk Factors for Mortality?". (2022), 261-267. https://doi.org/10.5578/flora.20229809 |
| APA | tosun p, Karaşahin Ö, Karahan B, Kiziltunc H, Albayrak A (2022). Candidemia in Older Adults: What Are the Risk Factors for Mortality?. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 27(2), 261 - 267. 10.5578/flora.20229809 |
| Chicago | tosun pinar,Karaşahin Ömer,Karahan Büşra,Kiziltunc Husnu Serdar,Albayrak Ayse Candidemia in Older Adults: What Are the Risk Factors for Mortality?. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi 27, no.2 (2022): 261 - 267. 10.5578/flora.20229809 |
| MLA | tosun pinar,Karaşahin Ömer,Karahan Büşra,Kiziltunc Husnu Serdar,Albayrak Ayse Candidemia in Older Adults: What Are the Risk Factors for Mortality?. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, vol.27, no.2, 2022, ss.261 - 267. 10.5578/flora.20229809 |
| AMA | tosun p,Karaşahin Ö,Karahan B,Kiziltunc H,Albayrak A Candidemia in Older Adults: What Are the Risk Factors for Mortality?. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi. 2022; 27(2): 261 - 267. 10.5578/flora.20229809 |
| Vancouver | tosun p,Karaşahin Ö,Karahan B,Kiziltunc H,Albayrak A Candidemia in Older Adults: What Are the Risk Factors for Mortality?. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi. 2022; 27(2): 261 - 267. 10.5578/flora.20229809 |
| IEEE | tosun p,Karaşahin Ö,Karahan B,Kiziltunc H,Albayrak A "Candidemia in Older Adults: What Are the Risk Factors for Mortality?." Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 27, ss.261 - 267, 2022. 10.5578/flora.20229809 |
| ISNAD | tosun, pinar vd. "Candidemia in Older Adults: What Are the Risk Factors for Mortality?". Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi 27/2 (2022), 261-267. https://doi.org/10.5578/flora.20229809 |
