Predicting candidemia in the internal medicine wards: a comparison with gram-negative bacteremia-a retrospectives study

Diagn Microbiol Infect Dis. 2019 Sep;95(1):80-83. doi: 10.1016/j.diagmicrobio.2019.04.007. Epub 2019 Apr 26.

Abstract

Introduction: Risk factors for candidemia in the internal medicine wards (IMW) are poorly characterized. Their elucidation might assist in early diagnosis and treatment.

Objectives: We aimed to elucidate predictors of candidemia in the IMWs comparing them to patients with gram-negative bacteremia (GNB).

Methods: A retrospective study of consecutive patients with candidemia in IMWs in Beilinson hospital (2007-2016) was performed. Patient demographics, comorbidities, and clinical characteristics were documented. The comparator group was GNB patients.

Results: Sixty-two patients with candidemia were compared with 178 patients with GNB. Candidemic patients were younger and with less body mass index > 20 kg/m2 (73 ± 15 vs. 78 ± 10, P = 0.01; 44% vs. 60%, P = <0.0001,respectively). In multivariate model, underweight, prior cephalosporin use, and central venous catheters (CVCs) were significantly associated with candidemia [odds ratio (OR) = 0.2, 95% confidence interval (CI) 0.07-0.4; OR = 4, 95% CI 1.3-11; and OR = 4, 95% CI 1.5-12, respectively].

Conclusion: Underweight, recent cephalosporin exposure, and CVCs were statistically significant predictors of candidemia in the IMW. Using these predictors might aid in recognizing high-risk patients for candidemia in the IMWs, leading to earlier appropriate empirical treatment.

Keywords: Candidemia; Medical wards; Predictors.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bacteremia / epidemiology*
  • Blood Culture
  • Candida / isolation & purification
  • Candidemia / diagnosis
  • Candidemia / epidemiology*
  • Female
  • Gram-Negative Bacteria / physiology
  • Hospitals
  • Humans
  • Internal Medicine / statistics & numerical data*
  • Israel / epidemiology
  • Male
  • Middle Aged
  • Odds Ratio
  • Retrospective Studies
  • Risk Factors