Predictive value of Candida colonization index in 131 patients undergoing two different cardiovascular surgical procedures.
BACKGROUND
Nosocomial candidemia is an important infection because of its increasing incidence and its high fatality rate. Candidiasis involves multiple risk factors. In this work, we study the degree of Candida colonization in cardiovascular surgical patients by taking into account the number of sites colonized and the density of growth.


METHODS
Eleven (11) selected variables (age, sex, weight, diabetes, number of antibiotics, duration of antibiotics, length of hospitalization, length of stay in surgical intensive care unit, duration of surgery, temperature during surgery, and number of bypass) were considered to predict the perioperative variation of the colonization index (CI) by Candida in 131 cardiovascular surgical patients. These patients were divided into two groups: group A, coronary artery bypass grafting with extracorporeal circulation (72 patients) and group B, coronary artery bypass grafting without extracorporeal circulation (59 patients).


RESULTS
One thousand and forty-eight fungal cultures were obtained from four different body sites and 162 isolated were identified. Candida albicans accounted for 74% of the strains in group A and 97% in group B. The statistical analysis (two-way anova) shows that group A patients with an increased CI have received significantly more antibiotics than those with a stable CI (1.50+/-0.83 vs 1.08+/- 0.40, p=0.0055).


CONCLUSIONS
Epidemiological data obtained from this study show that coronary artery bypass grafting with extracorporeal circulation procedure is associated with an increase in the use of antibiotics and subsequently a higher risk a Candida colonization-infection.
Yazdanparast
K
K
Department of Microbiology, Montreal Heart Institute, Quebec, Canada.
Auger
P
P
Marchand
R
R
Carrier
M
M
Cartier
R
R
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D002175:Candida / Q000145:classification / Q000302:isolation & purification; D002177:Candidiasis / Q000209:etiology*; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D003428:Cross Infection / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012307:Risk Factors
D000900:Anti-Bacterial Agents