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Host Factors and Clinical Outcomes of Candida Colonization in Critically Ill Patients

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Abstract

This study aimed to describe factors and outcomes associated with Candida colonization of critically ill patients. This was a cross-sectional study conducted over 2 weeks in the intensive care unit (ICU) of a tertiary care hospital at the Texas Medical Center, Houston, TX. All Candida samples were prospectively collected with demographic and clinical data collected retrospectively. We examined 48 patients, 32 (67 %) were colonized with Candida spp; 25 (52.1 %) patients were isolated with Candida albicans and 18 (37.5 %) were isolated with a non-albicans species, mostly commonly Candida glabrata. A multivariate analysis identified proton pump inhibitor administration at admission to ICU [odds ratio 5.66; 95 % confidence interval 1.12–28.5] as associated with colonization. Patients colonized with Candida had a significantly longer length of ICU and hospital stays (7.6 ± 6.6 vs. 4.2 ± 2.6 days, P = 0.01 and 14.9 ± 12.9 vs. 7.5 ± 6.7 days, P = 0.02, respectively). Clonality testing between C. albicans and C. glabrata strains identified indistinguishable strains among the patient cohort. These data provide additional information on Candida colonization in critically ill patients.

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References

  1. Sievert DM, Ricks P, Edwards JR, Schneider A, Patel J, Srinivasan A, et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009–2010. Infect Control Hosp Epidemiol. 2013;34(1):1–14. doi:10.1086/668770.

    Article  PubMed  Google Scholar 

  2. Eggimann P, Garbino J, Pittet D. Epidemiology of Candida species infections in critically ill non-immunosuppressed patients. Lancet Infect Dis. 2003;3(11):685–702.

    Article  PubMed  Google Scholar 

  3. Hammarskjold F, Mernelius S, Andersson RE, Berg S, Hanberger H, Lofgren S, et al. Possible transmission of Candida albicans on an intensive care unit: genotype and temporal cluster analyses. J Hosp Infect. 2013;85(1):60–5. doi:10.1016/j.jhin.2013.06.002.

    Article  CAS  PubMed  Google Scholar 

  4. Palabiyikoglu I, Oral M, Tulunay M. Candida colonization in mechanically ventilated patients. J Hosp Infect. 2001;47(3):239–42. doi:10.1053/jhin.2000.0897.

    Article  CAS  PubMed  Google Scholar 

  5. Olaechea PM, Palomar M, Leon-Gil C, Alvarez-Lerma F, Jorda R, Nolla-Salas J, et al. Economic impact of Candida colonization and Candida infection in the critically ill patient. Eur J Clin Microbiol Infect Dis. 2004;23(4):323–30. doi:10.1007/s10096-004-1104-x.

    Article  CAS  PubMed  Google Scholar 

  6. Liguori G, Lucariello A, Colella G, De Luca A, Marinelli P. Rapid identification of Candida species in oral rinse solutions by PCR. J Clin Pathol. 2007;60(9):1035–9. doi:10.1136/jcp.2006.040782.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Wise MG, Healy M, Reece K, Smith R, Walton D, Dutch W, et al. Species identification and strain differentiation of clinical Candida isolates using the DiversiLab system of automated repetitive sequence-based PCR. J Med Microbiol. 2007;56(Pt 6):778–87. doi:10.1099/jmm.0.47106-0.

    Article  CAS  PubMed  Google Scholar 

  8. Mojazi Amiri H, Frandah W, Colmer-Hamood J, Raj R, Nugent K. Risk factors of Candida colonization in the oropharynx of patients admitted to an intensive care unit. J Mycol Med. 2012;22(4):301–7. doi:10.1016/j.mycmed.2012.08.001.

    Article  CAS  PubMed  Google Scholar 

  9. Janarthanan S, Ditah I, Adler DG, Ehrinpreis MN. Clostridium difficile-associated diarrhea and proton pump inhibitor therapy: a meta-analysis. Am J Gastroenterol. 2012;107(7):1001–10. doi:10.1038/ajg.2012.179.

    Article  CAS  PubMed  Google Scholar 

  10. ASHP Therapeutic Guidelines on Stress Ulcer Prophylaxis. ASHP Commission on Therapeutics and approved by the ASHP Board of Directors on November 14, 1998. Am J Health Syst Pharm. 1999;56(4):347–79.

    Google Scholar 

  11. Delisle MS, Williamson DR, Perreault MM, Albert M, Jiang X, Heyland DK. The clinical significance of Candida colonization of respiratory tract secretions in critically ill patients. J Crit Care. 2008;23(1):11–7. doi:10.1016/j.jcrc.2008.01.005.

    Article  PubMed  Google Scholar 

  12. Saghrouni F, Ben Abdeljelil J, Boukadida J, Ben Said M. Molecular methods for strain typing of Candida albicans: a review. J Appl Microbiol. 2013;114(6):1559–74. doi:10.1111/jam.12132.

    Article  CAS  PubMed  Google Scholar 

  13. Dodgson AR, Pujol C, Denning DW, Soll DR, Fox AJ. Multilocus sequence typing of Candida glabrata reveals geographically enriched clades. J Clin Microbiol. 2003;41(12):5709–17.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Bougnoux ME, Morand S, d’Enfert C. Usefulness of multilocus sequence typing for characterization of clinical isolates of Candida albicans. J Clin Microbiol. 2002;40(4):1290–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Shin JH, Bougnoux ME, d’Enfert C, Kim SH, Moon CJ, Joo MY, et al. Genetic diversity among Korean Candida albicans bloodstream isolates: assessment by multilocus sequence typing and restriction endonuclease analysis of genomic DNA by use of BssHII. J Clin Microbiol. 2011;49(7):2572–7. doi:10.1128/JCM.02153-10.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Myoung Y, Shin JH, Lee JS, Kim SH, Shin MG, Suh SP, et al. Multilocus sequence typing for Candida albicans isolates from candidemic patients: comparison with Southern blot hybridization and pulsed-field gel electrophoresis analysis. Korean J Lab Med. 2011;31(2):107–14. doi:10.3343/kjlm.2011.31.2.107.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Chen KW, Lo HJ, Lin YH, Li SY. Comparison of four molecular typing methods to assess genetic relatedness of Candida albicans clinical isolates in Taiwan. J Med Microbiol. 2005;54(Pt 3):249–58.

    Article  CAS  PubMed  Google Scholar 

  18. Asmundsdottir LR, Erlendsdottir H, Gisladottir AL, Gottfredsson M. Molecular epidemiology of late recurrent candidaemia–a population-based study in Iceland. Clin Microbiol Infect. 2012;18(2):195–201. doi:10.1111/j.1469-0691.2011.03595.x.

    Article  CAS  PubMed  Google Scholar 

  19. Marol S, Yucesoy M. Molecular epidemiology of Candida species isolated from clinical specimens of intensive care unit patients. Mycoses. 2008;51(1):40–9. doi:10.1111/j.1439-0507.2007.01435.x.

    CAS  PubMed  Google Scholar 

  20. Fanello S, Bouchara JP, Jousset N, Delbos V, LeFlohic AM. Nosocomial Candida albicans acquisition in a geriatric unit: epidemiology and evidence for person-to-person transmission. J Hosp Infect. 2001;47(1):46–52. doi:10.1053/jhin.2000.0849.

    Article  CAS  PubMed  Google Scholar 

  21. Pertowski CA, Baron RC, Lasker BA, Werner SB, Jarvis WR. Nosocomial outbreak of Candida albicans sternal wound infections following cardiac surgery traced to a scrub nurse. J Infect Dis. 1995;172(3):817–22.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. University at Buffalo School of Pharmacy and Pharmaceutical Sciences, 313 Kapoor Hall, Buffalo, NY, 14221, USA

    David M. Jacobs

  2. University of Houston College of Pharmacy, 1441 Moursund St, Houston, TX, 77030, USA

    Nicholas D. Beyda, M. Jahangir Alam & Kevin W. Garey

  3. Naresuan University, 99 Moo 9 Tambon Tha Pho, Muang, 65000, Thailand

    Orarik Asuphon

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  1. David M. Jacobs
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  2. Nicholas D. Beyda
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  3. Orarik Asuphon
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  4. M. Jahangir Alam
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  5. Kevin W. Garey
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Corresponding author

Correspondence to David M. Jacobs.

Additional information

During the time this study was conducted, Dr. Jacobs was an Infectious Diseases Resident, University of Houston College of Pharmacy, Houston, TX, USA.

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Jacobs, D.M., Beyda, N.D., Asuphon, O. et al. Host Factors and Clinical Outcomes of Candida Colonization in Critically Ill Patients. Mycopathologia 179, 87–93 (2015). https://doi.org/10.1007/s11046-014-9809-6

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  • DOI: https://doi.org/10.1007/s11046-014-9809-6

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