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Hyeon Woo Byun, 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 Su |
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Department of Internal Medicine, Hanyang University College of Medicine |
| 원저 : 한 화상 전문 병원에서 최근 5년간 칸디다혈증의 임상적 특성과 사망률 고찰 (Original Articles : A 5-year review of clinical characteristics and mortality of burn patients with candidemia in a tertiary burn center) |
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변현우, 김철홍, 김진경, 엄광석, 박용범, 장승훈, 우흥정, 김동규, 이명구, 현인규, 정기석 |
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| 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¡¾20.9% 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.(Korean J Med
70:298-308, 2006)
Key Words : Burn, Candida |
| Key Words:
Burn, Candida |
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