Original Articles
Incidence and Risk Factors Associated with Candida Bloodstream Infections in Immunocompromised Patients | |
Dr. Gaurav Goel | |
Aim: The aim of this study was to determine the incidence and identify the risk factors associated with Candida bloodstream infections (BSIs) in immunocompromised patients during their hospital stay. Materials and Methods: This prospective observational study was conducted in a tertiary care hospital, enrolling 80 immunocompromised patients with confirmed Candida bloodstream infections. Patients were recruited from various hospital wards, including ICU, hematology-oncology, and transplant units. Clinical and laboratory parameters were collected, including patient demographics, clinical risk factors, and laboratory values such as blood cultures, white blood cell counts, and C-reactive protein levels. Risk factors, including prolonged neutropenia, ICU stay, central venous catheter use, total parenteral nutrition, and broad-spectrum antibiotic therapy, were evaluated using multivariate logistic regression analysis. The primary outcome was the incidence of Candida BSIs, and secondary outcomes included identifying key risk factors and evaluating clinical outcomes. Results: The incidence of Candida bloodstream infections was 53.33 per 1,000 patient-days. The most commonly isolated species was Candida albicans (50%), followed by Candida glabrata (18.75%) and Candida parapsilosis (15%). Multivariate logistic regression identified significant risk factors for candidemia, including prolonged ICU stay (OR: 3.2, p=0.01), broad-spectrum antibiotic use (OR: 3.5, p=0.01), and central venous catheter use (OR: 2.8, p=0.03). Clinical improvement was observed in 75% of patients, while 12.50% had persistent infections and 12.50% died. Conclusion: Candida bloodstream infections present a significant burden in immunocompromised patients, particularly in those with prolonged ICU stays, neutropenia, and central venous catheters. Early diagnosis and prompt antifungal treatment tailored to Candida species can improve clinical outcomes, but mortality rates remain considerable in this vulnerable population. |
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