title: Predisposing factors for candidemia in patients with major burns.
abstract: BACKGROUND
  Despite advances in surgery and critical care, candidemia remains a significant cause of morbidity and mortality in patients with extensive burns.
  
  
  METHODS
  A retrospective single-center cohort study was performed on 174 patients admitted to the Burn Intensive Care Unit of the General Hospital of Vienna (2007-2013). An AIC based model selection procedure for logistic regression models was utilized to identify factors associated with the presence of candidemia.
  
  
  RESULTS
  Twenty (11%) patients developed candidemia on median day 16 after ICU admission associated with an increased overall mortality (30% versus 10%). Statistical analysis identified the following factors associated with proven candidemia: younger age (years) odds ratio (OR):0.96, 95% confidence interval (95% CI):0.92-1.0, female gender (reference male) OR:5.03, 95% CI:1.25-24.9, gastrointestinal (GI) complications requiring surgery (reference no GI complication) OR:20.37, 95% CI:4.25-125.8, non-gastrointestinal thromboembolic complications (reference no thromboembolic complication) OR:17.3, 95% CI:2.57-170.4 and inhalation trauma (reference no inhalation trauma) OR:7.96, 95% CI:1.4-48.4.
  
  
  CONCLUSIONS
  Above-mentioned patient groups are at considerably high risk for candidemia and might benefit from a prophylactic antifungal therapy. Younger age as associated risk factor is likely to be the result of the fact that older patients with a great extent of burn body surface have a lower chance of survival compared to younger patients with a comparable TBSA.
authors.affiliation: Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria. Electronic address: alexandra.fochtmann@meduniwien.ac.at.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Fochtmann
authors.affiliation: Medical University of Vienna, Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Vienna, Austria. Electronic address: christina.a.forstner@meduniwien.ac.at.
authors.forename: Christina
authors.initials: C
authors.lastname: Forstner
authors.affiliation: Medical University of Vienna, Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Vienna, Austria. Electronic address: michael.hagmann@meduniwien.ac.at.
authors.forename: Michael
authors.initials: M
authors.lastname: Hagmann
authors.affiliation: Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria. Electronic address: maike.keck@meduniwien.ac.at.
authors.forename: Maike
authors.initials: M
authors.lastname: Keck
authors.affiliation: Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria. Electronic address: gabriela.muschitz@meduniwien.ac.at.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Muschitz
authors.affiliation: Medical University of Vienna, Clinical Institute of Infection Control and Hospital Epidemiology, Vienna, Austria. Electronic address: elisabeth.presterl@meduniwien.ac.at.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Presterl
authors.affiliation: Medical University of Vienna, Department of Anesthesiology and General Intensive Care, Vienna, Austria. Electronic address: gerald.ihra@meduniwien.ac.at.
authors.forename: Gerald
authors.initials: G
authors.lastname: Ihra
authors.affiliation: Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria. Electronic address: thomas.rath@meduniwien.ac.at.
authors.forename: Thomas
authors.initials: T
authors.lastname: Rath
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D002056:Burns / Q000150:complications*; D058387:Candidemia / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000935:Antifungal Agents
keywords: Antifungal therapy; Candidemia; Gastrointestinal complications; Severe burn injury; Thermal injury; Thromboembolic complications