Erişkin Yoğun Bakım Ünitesinde Yatan Hastalarda Kandidemi Risk Faktörlerinin Belirlenmesi

Tokak, Semih; Uğurcan, Doğaç; Tekindal, Mustafa Agâh

doi:10.5578/flora.68473

Cited by 4 publications

(1 citation statement)

References 37 publications

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“…In our study, C. parapsilosis was the leading agent of candidemia (n = 7, 43%), C. tropicalis at (n = 5, 31%) was the second, and C. albicans (n = 4, 25%) was the third. Similarly, Tokak et al (2020) ranked C. parapsilosis (48.4%) the first and C. albicans (32.3%) the second in candidemia. Cortés et al (2021) identified C. parapsilosis as the most common factor (38.5%) in their study.…”

Section: Discussionmentioning

confidence: 95%

Fungal Infections in COVID-19 Intensive Care Patients

Coşkun¹,

Durmaz²

2021

Polish Journal of Microbiology

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Opportunistic fungal infections increase morbidity and mortality in COVID-19 patients monitored in intensive care units (ICU). As patients’ hospitalization days in the ICU and intubation period increase, opportunistic infections also increase, which prolongs hospital stay days and elevates costs. The study aimed to describe the profile of fungal infections and identify the risk factors associated with mortality in COVID-19 intensive care patients. The records of 627 patients hospitalized in ICU with the diagnosis of COVID-19 were investigated from electronic health records and hospitalization files. The demographic characteristics (age, gender), the number of ICU hospitalization days and mortality rates, APACHE II scores, accompanying diseases, antibiotic-steroid treatments taken during hospitalization, and microbiological results (blood, urine, tracheal aspirate samples) of the patients were recorded. Opportunistic fungal infection was detected in 32 patients (5.10%) of 627 patients monitored in ICU with a COVID-19 diagnosis. The average APACHE II score of the patients was 28 ± 6. While 25 of the patients (78.12%) died, seven (21.87%) were discharged from the ICU. Candida parapsilosis (43.7%) was the opportunistic fungal agent isolated from most blood samples taken from COVID-19 positive patients. The mortality rate of COVID-19 positive patients with candidemia was 80%. While two out of the three patients (66.6%) for whom fungi were grown from their tracheal aspirate died, one patient (33.3%) was transferred to the ward. Opportunistic fungal infections increase the mortality rate of COVID-19-positive patients. In addition to the risk factors that we cannot change, invasive procedures should be avoided, constant blood sugar regulation should be applied, and unnecessary antibiotics use should be avoided.

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Section: Discussionmentioning

confidence: 95%

Fungal Infections in COVID-19 Intensive Care Patients

Coşkun¹,

Durmaz²

2021

Polish Journal of Microbiology

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Comparison of Candida colonization in intensive care unit patients with and without COVID-19: First prospective cohort study from Turkey

Çaklovica Küçükkaya,

Orhun,

Çağatay

et al. 2024

Medical Mycology

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Candida species are the primary cause of fungal infections in intensive care units (ICUs). Despite the increasing prevalence of Candida-related infections, monitoring the progression of these infections from colonization in COVID-19 ICU patients lacks sufficient information. This study aims prospectively to compare 62 COVID-19 and 60 non-COVID-19 ICU patients from admission to discharge in terms of colonization development, rates, isolated Candida species, risk factors, and Candida infections during hospitalization. A total of 1464 samples collected at specific time intervals from various body sites [mouth, skin (axilla), rectal, and urine]. All samples were inoculated onto CHROMagar Candida and CHROMagar Candida Plus media, with isolates identified using MALDI-TOF MS. COVID-19 patients exhibited significantly higher colonization rates in oral, rectal, and urine samples compared to non-COVID-19 patients, (p<0.05). Among the Candida species, non-albicans Candida was more frequently detected in COVID-19 patients, particularly in oral (75.8%-25%; p<0.001) and rectal regions (74.19%-46.66%; p< 0.05). Colonization with mixed Candida species was also more prevalent in the oropharyngeal region (p<0.05). Mechanical ventilation and corticosteroid use emerged as elevated risk factors among COVID-19 patients (p<0.05). Despite the colonization prevalence, both COVID-19-positive and negative patients exhibited low incidences of Candida infections, with rates of 9.67% (n=6/62) and 6.67% (n=3/60), respectively. Consequently, although Candida colonization rates were higher in COVID-19 ICU patients, there was no significant difference in Candida infection development compared to the non-COVID-19 group. However, the elevated rate of non-albicans Candida isolates highlights potential future infections, particularly given their intrinsic resistance in prophylactic or empirical treatments if needed. Additionally, the high rate of mixed colonization emphasizes the importance of using chromogenic media for routine evaluation.

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Fungal infection profile in critically ill COVID-19 patients: a prospective study at a large teaching hospital in a middle-income country

et al. 2023

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Background Critically ill COVID-19 patients are highly susceptible to opportunistic fungal infection due to many factors, including virus-induced immune dysregulation, host-related comorbidities, overuse and misuse of antibiotics or corticosteroids, immune modulator drugs, and the emergencies caused by the pandemic. This study aimed to assess the incidence, identify the potential risk factors, and examine the impact of fungal coinfection on the outcomes of COVID-19 patients admitted to the intensive care unit (ICU). Methods A prospective cohort study including 253 critically ill COVID-19 patients aged 18 years or older admitted to the isolation ICU of Zagazig University Hospitals over a 4-month period from May 2021 to August 2021 was conducted. The detection of a fungal infection was carried out. Results Eighty-three (83) patients (32.8%) were diagnosed with a fungal coinfection. Candida was the most frequently isolated fungus in 61 (24.1%) of 253 critically ill COVID-19 patients, followed by molds, which included Aspergillus 11 (4.3%) and mucormycosis in five patients (1.97%), and six patients (2.4%) diagnosed with other rare fungi. Poor diabetic control, prolonged or high-dose steroids, and multiple comorbidities were all possible risk factors for fungal coinfection [OR (95% CI) = 10.21 (3.43–30.39), 14.1 (5.67–35.10), 14.57 (5.83–33.78), and 4.57 (1.83–14.88), respectively]. Conclusion Fungal coinfection is a common complication of critically ill COVID-19 patients admitted to the ICU. Candidiasis, aspergillosis, and mucormycosis are the most common COVID-19-associated fungal infections and have a great impact on mortality rates.

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Erişkin Yoğun Bakım Ünitesinde Yatan Hastalarda Kandidemi Risk Faktörlerinin Belirlenmesi

Cited by 4 publications

References 37 publications

Fungal Infections in COVID-19 Intensive Care Patients

Fungal Infections in COVID-19 Intensive Care Patients

Comparison of Candida colonization in intensive care unit patients with and without COVID-19: First prospective cohort study from Turkey

Fungal infection profile in critically ill COVID-19 patients: a prospective study at a large teaching hospital in a middle-income country

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