Diagnosis and variables associated with the development of candidemia in hight risk patients hospitalized of the University Hospital UNICAMP / Diagnostico e variaveis associadas a ocorrencia de candidemia em pacientes internados no Hospital de Clinicas da UNICAMP

AUTOR(ES)
DATA DE PUBLICAÇÃO

2005

RESUMO

The diagnosis of candidemia is important for prompt initiation of antifungal therapy. Two hundred and twenty-five patients with high risk for candidemia who had blood cultures drawn and were hospitalized more than 15 days were prospectively followed-up in a two-year period. Whole-blood cultures by automated BactAlert® system and PCR were used to detect candidemia in all patients hospitalized for more than 15 days in high-risk areas. DNA was extracted and amplified using ITS5 and ITS4 base pair primers and the PCR products were sequenced for identification of Candida spp. Positive blood culture for Candida was considered the gold standard for candidemia diagnosis. Variables associated with the development of candidemia diagnosed by positive blood culture were also evaluated in the patients. The overall mortality of the patients was 26.1% and the mortality rate in candidemic and non-candidemic patients was 41.9% and 22.5%, respectively (p=0.009). PCR sensitivity and specificity were 72.1% and 91.2%, respectively. Positive and negative predictive values were 65.9% and 93.2%, respectively. The logistic regression of the multivariate analysis showed that parenteral nutrition (p<.0001); urinary underlying catheter (p=0.0177), chemotherapy (p=0.0246) and steroids (p=0.0283) were significant variables associated with the development of candidemia. The PCR technique followed by DNA sequencing was a helpful tool, in candidemia diagnosis

ASSUNTO(S)

risk factors candidemia candidemia fatores de risco polimerase chain reaction reação em cadeia de polimerase sequencia de nucleotidios nucleotide sequence

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