title: Candidemia in Neurosurgical Intensive Care Unit: preliminary analysis of the effect of topical Nystatin prophylaxis and adequate source control on patients with early tracheostomy intubation.
abstract: BACKGROUND
  The present study represents a preliminary evaluation of the impact of topical nystatin prophylaxis administration and adequate CVC management on reducing the chance of developing candidemia in neurosurgical intensive care unit (NICU) patients.
  
  
  METHODS
  We conducted a case-control study at the nine bed NICU of the Policlinico "Umberto I" teaching hospital in Rome, Italy, during the period from January 2011 to July 2012. We compared eight patients with culture proven Candida bloodstream infection (CBSI) with a control group of 19 patients who did not have evidence of CBSI.
  
  
  RESULTS
  When the CBSI group was compared with the control group, the former were more likely than controls to not have received nystatin prophylaxis and adequate catheter care (p= 0,008). When CBSI group was matched with patients with no adequate source control and nystatin prophylaxis, average NICU stay (71.13 days vs 19.0 days) was significant (mean difference = -52.12 days, 95% CI -97.11 to -7.14, p= 0.028). The same was true for mean time of glucocorticoid exposure (mean difference = -10.5 days, 95% CI -17.35 to -3.65, p<0.01). Binary logistic regression analysis demonstrated no significant association between topical nystatin prophylaxis (p= 0.99), length of NICU stay (p= 0.99), time of glucocorticoid exposure (p= 0.99) and candidemia.
  
  
  CONCLUSIONS
  Topical prophylaxis with nystatin and adequate source control proved to be effective in preventing invasive candidiasis in patients admitted to the NICU.
authors: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.
authors: S
authors: S
authors: Giuliano
authors: G
authors: G
authors: Ceccarelli
authors: V
authors: V
authors: Renzini
authors: G
authors: G
authors: Magni
authors: F
authors: F
authors: Baisi
authors: M
authors: M
authors: Santini
authors: M
authors: M
authors: Venditti
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000008:administration & dosage*; D058387:Candidemia / Q000517:prevention & control*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery; D009761:Nystatin / Q000008:administration & dosage*; D014139:Tracheostomy
chemical_list: D000935:Antifungal Agents; D009761:Nystatin