Incidence and risk factors for COVID-19 associated candidemia (CAC) in ICU patients

KAYAASLAN B., KAYA KALEM A., Asilturk D., Kaplan B., Dönertas G., HASANOĞLU İ., ...Daha Fazla

Mycoses, cilt.65, sa.5, ss.508-516, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 65 Sayı: 5
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1111/myc.13431
  • Dergi Adı: Mycoses
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Sayfa Sayıları: ss.508-516
  • Anahtar Kelimeler: candida, candidemia, COVID-19, COVID-19 associated candidemia, incidence, risk factors
  • Ankara Yıldırım Beyazıt Üniversitesi Adresli: Evet

Özet

© 2022 Wiley-VCH GmbH.Background: Critically ill COVID-19 patients have a high risk for the development of candidemia due to being exposed to both well-defined classical risk factors and COVID-19-specific risk factors in ICU. Objectives: In this study, we investigated the incidence of candidemia in critically COVID-19 patients, and the independent risk factors for candidemia. Patients/methods: COVID-19 patients hospitalised in ICU during 1-year period (August 2020 to August 2021) were included. Clinical and laboratory characteristics of all COVID-19 patients, applied treatments, and invasive procedures that may predispose to candidemia were recorded. Results: Of 1229 COVID-19 patients, 63 developed candidemia. Candidemia incidence rate was 4.4 episodes per 1000 ICU days. The most common species was Candida albicans (52.3%). Only 37 patients (58.7%) received antifungal therapy. The presence of central venous catheter (OR 4.7, 95% CI 1.8–12.2, p <.005), multifocal candida colonisation (OR 2.7, 95% CI 1.4–5.2, p <.005), a prolonged ICU stay (≥14 days) (OR 1.9, 95% CI 1.08–3–37, p <.05), the absence of chronic lung disease (OR 0.4, 95% CI 0.1–0.9, p <.05) and the absence of corticosteroid use (OR 0.3, 95% CI 0.14–0.52, p <.0001) were significantly associated with candidemia. Conclusions: Our study filled the knowledge gap in the literature about the impact of COVID-19-associated risk factors for the development of candidemia. The classical risk factors for candidemia had a significant effect on candidemia, and contrary to expectations, corticosteroids had a protective effect against the development of candidemia. The results of these studies showing interesting effects of corticosteroids in critically ill COVID-19 patients should be confirmed by further studies.