Creation and assessment of a clinical predictive model for candidaemia in patients with candiduria.
Candida spp
candidemia
candiduria
clinical prediction model
colonisation
protective factors
risk factors
systemic infection
Journal
Mycoses
ISSN: 1439-0507
Titre abrégé: Mycoses
Pays: Germany
ID NLM: 8805008
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
27
02
2019
revised:
19
04
2019
accepted:
20
04
2019
pubmed:
27
4
2019
medline:
17
8
2019
entrez:
27
4
2019
Statut:
ppublish
Résumé
Candidaemia is the most common clinical presentation of invasive candidiasis and is a major cause of morbidity and mortality. Candiduria is a predictor for candidaemia; however, patient characteristics that are associated with concurrent candidaemia in the setting of candiduria are unclear. Identifying these characteristics could aid in the early detection of systemic disease. We performed a retrospective cohort analysis of hospitalised patients with candiduria at our institution over a 13-year period. Our evaluation of patient characteristics included demographics, comorbidities, medications, procedures, devices, vital signs and laboratory values. We developed a multivariable logistic model to identify factors associated with candidaemia in patients with candiduria. We identified 4240 patients with candiduria, 263 (6.2%) of whom had candidaemia. Predictors for increased risk of candidaemia with candiduria included hospitalisations > 12 days, central venous catheter, parenteral nutrition, haematological and gynaecological malignancy, and receipt of β-lactam/β-lactamase inhibitors. Vital signs and laboratory values associated with candidaemia included elevated heart rate, temperature and creatinine, along with neutropenia and neutrophilia. Factors that demonstrated a decreased risk of candidaemia included diabetes mellitus, gastrostomy and urinary catheter with antibiotic use. The c-statistic was 0.741 (95% CI, 0.710-0.772). We identified a set of clinical characteristics that can predict the presence of candidaemia with candiduria.
Identifiants
pubmed: 31025417
doi: 10.1111/myc.12917
pmc: PMC6565491
mid: NIHMS1025895
doi:
Types de publication
Journal Article
Langues
eng
Pagination
554-561Subventions
Organisme : NCI NIH HHS
ID : T32 CA190194
Pays : United States
Organisme : National Center for Advancing Translational Sciences (NCATS)
ID : UL1TR002345
Organisme : Astellas Pharma Global Development
ID : MYCA-15L03
Organisme : National Cancer Institute
Organisme : National Institute of Health (NIH)
ID : T32CA190194
Organisme : Washington University Institute of Clinical and Translational Sciences
Organisme : NCATS NIH HHS
ID : UL1 TR002345
Pays : United States
Informations de copyright
© 2019 Blackwell Verlag GmbH.
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