A 5-year review of clinical characteristics and mortality of burn patients with candidemia in a tertiary burn center.
- Author:
Hyeon Woo BYUN
1
;
Cheol Hong KIM
;
Jin Kyung KIM
;
Kwang Seok EOM
;
Young Bum PARK
;
Seung Hun JANG
;
Heung Jeong WOO
;
Dong Gyu KIM
;
Myung Goo LEE
;
In Gyu HYUN
;
Ki Suck JUNG
;
Jong Hyun KIM
;
Jae Jung LEE
;
Kyu Man LEE
Author Information
1. Department of Internal Medicine, College of Medicine, Hallym University, Seoul, Korea. ighyun@hallym.ac.kr
- Publication Type:Original Article
- Keywords:
Burn;
Candida
- MeSH:
Body Surface Area;
Burn Units*;
Burns*;
Candida;
Candida albicans;
Candidemia*;
Catheterization;
Catheters;
Causality;
Central Venous Catheters;
Humans;
Korea;
Mortality*;
Multivariate Analysis;
Respiration, Artificial;
Retrospective Studies;
Tracheostomy
- From:Korean Journal of Medicine
2006;70(3):298-308
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Nosocomial candidemia is one of the most common blood-stream infection and associated with a high fatality rate in burn patients. To determine the clinical characteristics, strains of Candida species and to identify contributing factors to death, we analyzed severely burned patients with candidemia. METHODS: 60 cases with candidemia were reviewed retrospectively from January 1999 to December 2003 at a tertiary burn center in Korea. Candidemia was defined as at least one blood culture that grew Candida organisms. RESULTS: Burn size of all patients were 46+/-20.9% of total body surface area burn and overall mortality was 41.7%. 97 strains of Candida species from 60 cases were isolated. Candida albicans was the most frequently isolated species (53.6%), followed by C. tropicalis (20.6%), C. glabrata (15.5%) and C. parapsilosis (10.3%). Among various predisposing factors for candidemia, significant factors associated with death were endotracheal tube insertion or tracheostomy, mechanical ventilation, the use of vasoactive agents, arterial catheterization and nasogastric tube insertion in univariate analysis, but significant independent factors for mortality were mechanical ventilation (OR=26.63, 95% CI; 1.60, 444.18, p=0.022) and the use of vasoactive agents (OR=23.18, 95% CI; 2.80, 192.35, p=0.004) in multivariate analysis. Among 59 patients indwelling central venous catheters, only 24 patients (40.7%) received antifungal therapy with catheter removal while 19 patients (32.2%) had antifungal therapy without catheter removal. CONCLUSIONS: Clinical severity, such as mechanical ventilation or vasoactive agents dependencies, may contribute to high fatality in severely burned patients with candidemia.
