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Candida Infections in Critically Ill Patients

  • D. Pittet
Conference paper
Part of the Yearbook of Intensive Care and Emergency Medicine 1994 book series (YEARBOOK, volume 1994)

Abstract

Nosocomial infection is a common complication of hospital admission; on average it complicates 8% of the admissions in general hospitals. Rates of infection are even higher for ICU patients than for those admitted to regular wards [1–3]. Although ICU make up only 5% of hospital beds, infections acquired in these units account for at least 20% of nosocomial infections. At the University of Iowa Hospitals and Clinics (UIHC) where prospective hospital-wide surveillance for nosocomial infections is conducted, the incidence of infections acquired in the ICU was 2 to 5 fold higher than in the regular wards [3]. Whereas overall rates of nosocomial infections ranged between 11 and 16 episodes per 1000 patient-days during the period from 1982 to 1989, they reached 36 to 54 per 1000 patient-days in the SICU, 23 to 47 per 1000 patient-days in the MICU, and 14 to 32 per 1000 patient-days in the PICU.

Keywords

Candida Albicans Nosocomial Infection Bloodstream Infection Candida Infection Candida Tropicalis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Daschner F, Frey P, Wolff G, Baumann PC, Suter P (1982) Nosocomial infections in intensive care wards: A multicenter prospective study. Intensive Care Med 8: 5–9Google Scholar
  2. 2.
    Donowitz LG (1986) High risk of nosocomial infection in the pediatric critical care patient. Crit Care Med 14: 26–28PubMedCrossRefGoogle Scholar
  3. 3.
    Pittet D, Herwaldt LA, Massanari RM (1992) The Intensive Care Unit. In: Brachman PS, Bennett JV (eds) Hospital Infections, 3rd Ed., Little, Brown and Company, Boston, MA, pp 405–439Google Scholar
  4. 4.
    Horn R, Wong B, Kiehn TE, Armstrong D (1985) Fungemia in a cancer hospital: Changing frequency, earlier onset, and results of therapy. Rev Infect Dis 7: 646–655Google Scholar
  5. 5.
    Solomkin JS, Flohr AB, Quie PG, Simmons RL (1980) The role of Candida in intraperitoneal infections. Surgery 88: 524–530PubMedGoogle Scholar
  6. 6.
    Sobel JD (1988) Candida infections in the intensive care unit. Crit Care Med 4: 325–344Google Scholar
  7. 7.
    Jarvis WR, Martone W (1992) Predominant pathogens in hospital infections. J Antimicrob Chemother 29 (Suppl A): 19–24PubMedCrossRefGoogle Scholar
  8. 8.
    Beck Sague C, Jarvis W (1993) Secular trends in the epidemiology of nosocomial fungal infections in the United States, 1980–1990. National Nosocomial Infections Surveillance System. J Infect Dis 167: 1247–1251Google Scholar
  9. 9.
    Pittet D, Wenzel RP (1992) Secular trends in rates and mortality of nosocomial bloodstream infections in a tertiary health care center. 31st Interscience Conference on Antimicrobial Agents and Chemotherapy. A1152 (Abst)Google Scholar
  10. 10.
    Wey SB, Mori M, Pfaller MA, Woolson RF, Wenzel RP (1989) Risk factors for hospital-acquired candidemia. A matched case-control study. Arch Intern Med 149: 2349–2353Google Scholar
  11. 11.
    Bross J, Talbot GH, Maislin G, Hurwits S, Strom BL (1989) Risk factors for nosocomial candidemia: A case-control study in adults without leukemia. Am J Med 87: 614–620Google Scholar
  12. 12.
    Pittet D (1993) Nosocomial bloodstream infections. In: Wenzel RP (ed) Prevention and control of nosocomial infections, 2nd Ed, Williams and Wilkins, Baltimore, pp 512–555Google Scholar
  13. 13.
    Wey SB, Motomi M, Pfaller MA, Woolson RF, Wenzel RP (1988) Hospital-acquired candidemia. The attributable mortality and excess lenght of stay. Arch Intern Med 148: 26422645Google Scholar
  14. 14.
    Miller PJ, Wenzel RP (1987) Etiologic organisms as independent predictors of death and morbidity associated with bloodstream infections. J Infect Dis 156: 471–477PubMedCrossRefGoogle Scholar
  15. 15.
    Pittet D, Monod M, Filthuth I, Frenk E, Suter PM, Auckenthaler R (1991) Contour-clamped homogeneous electric field gel electrophoresis as a powerful epidemiologic tool in yeast infections. Am J Med 91: 256S - 263SPubMedCrossRefGoogle Scholar
  16. 16.
    Craven DE, Kunches LM, Lichtenberg DA (1988) Nosocomial infection and fatality in medical surgical intensive care unit patients. Arch Intern Med 148: 1161PubMedCrossRefGoogle Scholar
  17. 17.
    Gross PA, DeMauro PJ, Van Antwerpen C, Wallenstein S, Chiang S (1988) Number of comorbidities as a predictor of nosocomial infection acquisition. Infect Control Hosp Epidemiol 9: 497–500PubMedCrossRefGoogle Scholar
  18. 18.
    Richet HM, Andremont A, Tancrede C, Pico JL, Jarvis WR (1991) Risk factors for candidemia in patients with acute lymphocytic leukemia. Rev Infect Dis 13: 211–215PubMedCrossRefGoogle Scholar
  19. 19.
    Solomkin JS, Flohr AB, Simmons RL (1982) Indications for therapy for fungemia in postoperative patients. Arch Surg 117: 1272–1275PubMedCrossRefGoogle Scholar
  20. 20.
    Solomon SL, Khabbaz RF, Parker RH, et al (1984) An outbreak of Candida parapsilosis bloodstream infections in patients receiving parenteral nutrition. J Infect Dis 149: 98–102PubMedCrossRefGoogle Scholar
  21. 21.
    Pappu-Katikaneni LD, Rao KP, Banister E (1990) Gastrointestinal colonization with yeast species and Candida septicemia in very low birth weight infants. Mycoses 33: 20–23PubMedGoogle Scholar
  22. 22.
    Pittet D, Monod M, Suter PM, Auckenthaler R (1991) Colonization: A prerequisite for severe candidal infection in critically ill patients. 31st Interscience Conference on Antimicrobial Agents and Chemotherapy A792 (Abst)Google Scholar
  23. 23.
    Nicolle LE, Hume K, Sims H, Rosenal T, Sandham D (1986) An outbreak of group A streptococcal bacteremia in an intensive care unit. Infect Control 7: 177–180PubMedGoogle Scholar
  24. 24.
    Pfaller MA, Cabezudo I, Hollis R, Huston B, Wenzel RP (1990) The use of biotyping and DNA fingerprinting in typing Candida albicans from hospitalized patients. Diagn Microbiol Infect Dis 13: 481–489PubMedCrossRefGoogle Scholar
  25. 25.
    Magee PT, Bowdin L, Staudinger J (1992) Comparison of molecular typing methods for Candida albicans. J Clin Microbiol 30: 2674–2679PubMedGoogle Scholar
  26. 26.
    Burnie JP, Odds FC, Lee W, Webster C, Williams J (1985) Outbreak of systemic Candida albicans in intensive care unit caused by cross infection. Br Med J 290: 746–748CrossRefGoogle Scholar
  27. 27.
    Vaudry WL, Tierney AJ, Wenman WM (1988) Investigation of a cluster of systemic Candida albicans infections in a neonatal intensive care unit. J Infect Dis 158: 1375–1379PubMedCrossRefGoogle Scholar
  28. 28.
    Sherertz RJ, Gledhill KS, Hampton KD, et al (1992) Outbreak of Candida bloodstream infections associated with retrograde medication administration in a neonatal intensive care unit. J Pediatr 120: 455–461PubMedCrossRefGoogle Scholar
  29. 29.
    Phelps M, Ayliffe GAJ, Babb JR (1986) An outbreak of candidiasis in a special care baby unit: The use of a resistogram typing method. J Hosp Infect 7: 13–20Google Scholar
  30. 30.
    Stevens DA, Odds FC, Scherer S (1990) Applications of DNA typing methods to Candida albicans epidemiology and correlations with phenotype. Rev Infect Dis 12: 258–266PubMedCrossRefGoogle Scholar
  31. 31.
    Weems JJ Jr., Chamberland ME, Ward J, Willy M, Padhye AA, Solomon SL (1987) Candida parapsilosis fungemia associated with parenteral nutrition and contaminated blood pressure transducers. J Clin Microbiol 25: 1029–1032PubMedGoogle Scholar
  32. 32.
    Lee W, Burnie JP, Matthews RC, Oppenheim BO, Damani NN (1991) Hospital outbreaks with yeasts. J Hosp Infect 18 (Suppl A): 237–249PubMedCrossRefGoogle Scholar
  33. 33.
    Isenberg DD, Tucci V, Cintron F, Singer C, Weinstein GS, Tyras DH (1989) Single-source outbreak of Candida tropicalis complicating coronary bypass surgery. J Clin Microbiol 27: 2426–2428PubMedGoogle Scholar
  34. 34.
    Doebbeling BN, Lehmann PF, Hollis RJ, et al (1993) Comparison of pulsed-field gel electrophoresis with isoenzyme profiles as a typing system for Candida tropicalis. Clin Infect Dis 16: 377–383PubMedCrossRefGoogle Scholar
  35. 35.
    Hiatt JR, Kobayashi MR, Doty JE, Ramming KP (1991) Acalculous candida cholecystitis: A complication of critical surgical illness. Am J Surg 57: 825–829Google Scholar
  36. 36.
    Jones JM (1990) Laboratory diagnosis of invasive candidiasis. Clin Microbiol Rev 3: 3245Google Scholar

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© Springer-Verlag Berlin Heidelberg 1994

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  • D. Pittet

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