title: [Systemic candidiasis in medical intensive care unit: analysis of risk factors and the contribution of colonization index].
abstract: OBJECTIVE
  Description of the epidemiological and clinical characteristics of the patients introducing risk factors of invasive candidiasis. Analysis of risk factors for candidiasis invasive and evaluation of the contribution of colonization index (CI) in the diagnosis of the systematic candidiasis in medical intensive care.
  
  
  METHODS
  Prospective observational study (October 2007 to October 2009). The selected patients present risk factors of system IC candidiasis with an infectious syndrome or clinical signs suggestive of Candida infection and hospitalized more than 48 hours in medical intensive care unit. Pittet's colonization index was calculated at admission and then once a week added to a blood culture. Patients were classified according to level of evidence of Candida infection and the degree of colonization (CI<0.5, CI ≥ 0.5).
  
  
  RESULTS
  The study included 100 patients. Mean age of our patients was 55.8 ± 18.2 years with male prevalence. Neurological disease was the most frequent pathology in admission (48%). The most common risk factors were broad-spectrum antibiotics and foreign material. In the various mycology IC specimens, Candida albicans was the most frequent, followed by C. tropicalis, then C. glabrata. The CI was greater than or equal to 0.5 at 53% of the patients, and less than 0.5 in 47% of the cases. Among the patients, 15% developed an invasive candidiasis. In multivariate analysis, the corticosteroid therapy was associated with a high colonisation (IC ≥ 0.5) and neutropenia with a high risk of systemic candidiasis. The positive predictive value of CI was 26%. The negative predictive value was 98%, the sensitivity and specificity was 93% and 48% respectively.
  
  
  CONCLUSIONS
  CI has the advantage to provide a quantified data of the patient's situation in relation to the colonization. But, it isn't helpful with patients having an invasive candidiasis in medical intensive care unit.
authors.affiliation: Service de réanimation médicale, hôpital militaire d'instruction Mohammed V, Rabat, Maroc.
authors.forename: S
authors.initials: S
authors.lastname: Massou
authors.forename: S
authors.initials: S
authors.lastname: Ahid
authors.forename: H
authors.initials: H
authors.lastname: Azendour
authors.forename: M
authors.initials: M
authors.lastname: Bensghir
authors.forename: K
authors.initials: K
authors.lastname: Mounir
authors.forename: M
authors.initials: M
authors.lastname: Iken
authors.forename: B E
authors.initials: BE
authors.lastname: Lmimouni
authors.forename: H
authors.initials: H
authors.lastname: Balkhi
authors.forename: N
authors.initials: N
authors.lastname: Drissi Kamili
authors.forename: C
authors.initials: C
authors.lastname: Haimeur
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida / Q000254:growth & development*; D002177:Candidiasis / Q000453:epidemiology* / Q000382:microbiology*; D002648:Child; D015169:Colony Count, Microbial; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult