title: Host factors and clinical outcomes of Candida colonization in critically ill patients.
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.
authors.affiliation: University at Buffalo School of Pharmacy and Pharmaceutical Sciences, 313 Kapoor Hall, Buffalo, NY, 14221, USA, dmjacobs@buffalo.edu.
authors.forename: David M
authors.initials: DM
authors.lastname: Jacobs
authors.forename: Nicholas D
authors.initials: ND
authors.lastname: Beyda
authors.forename: Orarik
authors.initials: O
authors.lastname: Asuphon
authors.forename: M Jahangir
authors.initials: MJ
authors.lastname: Alam
authors.forename: Kevin W
authors.initials: KW
authors.lastname: Garey
mesh_terms: D000368:Aged; D002175:Candida / Q000145:classification* / Q000302:isolation & purification / Q000472:pathogenicity*; D002177:Candidiasis / Q000382:microbiology* / Q000473:pathology; D003422:Critical Care; D016638:Critical Illness; D003428:Cross Infection / Q000382:microbiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D062606:Tertiary Care Centers