Factors’ analysis associated with adverse outcome of the treatment of patients with invasive candidiasis

Abstract

Introduction/Objective Invasive candidiasis (IC) is the most common invasive fungal infection in humans. It manifests as candidemia, and can affect internal organs and lead to sepsis and septic shock. A good knowledge of the factors that lead to the morbidity and mortality of these patients is necessary. We aimed to investigate the factors associated with the unfavorable outcome of patients with IC treated at our institution.

Methods The research was conducted at the Military Medical Academy in Belgrade, Serbia. The retrospective cohort study included 145 patients of both sexes, aged over 18, with a proven diagnosis of IC. Demographics, comorbidities, use of therapeutic procedures, antibiotics, antifungal treatment and outcome were compared between deceased and surviving patients with IC. The results were analyzed using Student’s t-test, Mann–Whitney U test, multivariate statistical analysis.

Results The results showed that the predictors of death were diabetes mellitus (adjusted OR 6.886; CI: 2.608–18.178; p = 0.000) and chemotherapy (adjusted OR 6.826; 95% CI: 2.037–22.866; p = 0.002), which increase the risk of death seven times compared to the basal risk and mechanical ventilation, which increases the risk of death about three times (adjusted OR: 3.056; 95% CI: 1.132–8.253; p = 0.012).

Conclusion Optimal treatment is necessary in terms of early detection and identification of the causative agent of IC. In susceptible patients, such as immunocompromised patients, appropriate treatment should be initiated as soon as possible.

Keywords: fungal infection; invasive candidiasis; diabetes mellitus; death