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Open Access 01-02-2008 | Research

Impact of invasive fungal infection on outcomes of severe sepsis: a multicenter matched cohort study in critically ill surgical patients

Authors: Guo-Hao Xie, Xiang-Ming Fang, Qiang Fang, Xin-Min Wu, Yu-Hong Jin, Jun-Lu Wang, Qu-Lian Guo, Miao-Ning Gu, Qiu-Ping Xu, Dong-Xin Wang, Shang-Long Yao, Shi-Ying Yuan, Zhao-Hui Du, Yun-Bo Sun, Hai-Hong Wang, Shui-Jing Wu, Bao-Li Cheng

Published in: Critical Care | Issue 1/2008

Abstract

Introduction

Fungal infection is increasingly common in critical illness with severe sepsis, but the influence of invasive fungal infection (IFI) on severe sepsis is not well understood. The aim of this study was to investigate the impact that IFI has on the outcomes of critically ill surgical patients with severe sepsis in China by means of matched cohort analysis; we also evaluated the epidemiologic characteristics of IFI in this population.

Methods

Records for all admissions to 10 university hospital surgical intensive care units (ICUs) from December 2004 to November 2005 were reviewed. Patients who met criteria for severe sepsis were included. IFI was identified using established criteria based on microbiologic or histological evidence. A matched cohort study was conducted to analyze the relationship between IFI and outcomes of severe sepsis.

Results

A total of 318 patients with severe sepsis were enrolled during the study period, of whom 90 (28.3%) were identified as having IFI. A total of 100 strains of fungi (58% Candida albicans) were isolated from these patients. Independent risk factors for IFI in patients with severe sepsis included mechanical ventilation (>3 days), Acute Physiology and Chronic Health Evaluation score, coexisting infection with both Gram-positive and Gram-negative bacteria, and urethral catheterization (>3 days). Compared with the control cohort, IFI was associated with increased hospital mortality (P < 0.001), high hospital costs (P = 0.038), and prolonged stay in the ICU (P < 0.001) and hospital (P = 0.020).

Conclusion

IFI is frequent in patients with severe sepsis in surgical ICUs and is associated with excess risk for hospital mortality, longer ICU and hospital stays, and greater consumption of medical resources.

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Title: Impact of invasive fungal infection on outcomes of severe sepsis: a multicenter matched cohort study in critically ill surgical patients
Authors: Guo-Hao Xie
Xiang-Ming Fang
Qiang Fang
Xin-Min Wu
Yu-Hong Jin
Jun-Lu Wang
Qu-Lian Guo
Miao-Ning Gu
Qiu-Ping Xu
Dong-Xin Wang
Shang-Long Yao
Shi-Ying Yuan
Zhao-Hui Du
Yun-Bo Sun
Hai-Hong Wang
Shui-Jing Wu
Bao-Li Cheng
Publication date: 01-02-2008
Publisher: BioMed Central
Published in: Critical Care / Issue 1/2008
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc6766

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of invasive fungal infection on outcomes of severe sepsis: a multicenter matched cohort study in critically ill surgical patients

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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