Time to blood culture positivity as a predictor of clinical outcome in patients with Candida albicans bloodstream infection
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/handle/11600/36879 http://dx.doi.org/10.1186/1471-2334-13-486 |
Resumo: | Background: Few studies have assessed the time to blood culture positivity as a predictor of clinical outcome in fungal bloodstream infections (BSIs). the purpose of this study was to evaluate the time to positivity (TTP) of blood cultures in patients with Candida albicans BSIs and to assess its impact on clinical outcome.Methods: A historical cohort study with 89 adults patients with C. albicans BSIs. TTP was defined as the time between the start of incubation and the time that the automated alert signal indicating growth in the culture bottle sounded.Results: Patients with BSIs and TTPs of culture of <= 36 h (n = 39) and >36 h (n = 50) were compared. Septic shock occurred in 46.2% of patients with TTPs of <= 36 h and in 40.0% of patients with TTP of >36 h (p = 0.56). A central venous catheter source was more common with a BSI TTP of <= 36 h (p = 0.04). Univariate analyis revealed that APACHE II score >= 20 at BSI onset, the development of at least one organ system failure (respiratory, cardiovascular, renal, hematologic, or hepatic), SOFA at BSI onset, SAPS II at BSI onset, and time to positivity were associated with death. By using logistic regression analysis, the only independent predictor of death was time to positivity (1.04; 95% CI, 1.0-1.1, p = 0.035), with the chance of the patient with C. albicans BSI dying increasing 4.0% every hour prior to culture positivity.Conclusion: A longer time to positivity was associated with a higher mortality for Candida albicans BSIs; therefore, initiating empiric treatment with antifungals may improve outcomes. |
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Nunes, Cintia Zoya [UNIFESP]Marra, Alexandre Rodrigues [UNIFESP]Edmond, Michael B.Victor, Elivane da SilvaPereira, Carlos Alberto Pires [UNIFESP]Universidade Federal de São Paulo (UNIFESP)Hosp Israelita Albert EinsteinVirginia Commonwealth2016-01-24T14:34:35Z2016-01-24T14:34:35Z2013-10-20Bmc Infectious Diseases. London: Biomed Central Ltd, v. 13, 7 p., 2013.1471-2334http://repositorio.unifesp.br/handle/11600/36879http://dx.doi.org/10.1186/1471-2334-13-486WOS000328901800001.pdf10.1186/1471-2334-13-486WOS:000328901800001Background: Few studies have assessed the time to blood culture positivity as a predictor of clinical outcome in fungal bloodstream infections (BSIs). the purpose of this study was to evaluate the time to positivity (TTP) of blood cultures in patients with Candida albicans BSIs and to assess its impact on clinical outcome.Methods: A historical cohort study with 89 adults patients with C. albicans BSIs. TTP was defined as the time between the start of incubation and the time that the automated alert signal indicating growth in the culture bottle sounded.Results: Patients with BSIs and TTPs of culture of <= 36 h (n = 39) and >36 h (n = 50) were compared. Septic shock occurred in 46.2% of patients with TTPs of <= 36 h and in 40.0% of patients with TTP of >36 h (p = 0.56). A central venous catheter source was more common with a BSI TTP of <= 36 h (p = 0.04). Univariate analyis revealed that APACHE II score >= 20 at BSI onset, the development of at least one organ system failure (respiratory, cardiovascular, renal, hematologic, or hepatic), SOFA at BSI onset, SAPS II at BSI onset, and time to positivity were associated with death. By using logistic regression analysis, the only independent predictor of death was time to positivity (1.04; 95% CI, 1.0-1.1, p = 0.035), with the chance of the patient with C. albicans BSI dying increasing 4.0% every hour prior to culture positivity.Conclusion: A longer time to positivity was associated with a higher mortality for Candida albicans BSIs; therefore, initiating empiric treatment with antifungals may improve outcomes.Universidade Federal de São Paulo UNIFESP, Div Infect Dis, São Paulo, BrazilHosp Israelita Albert Einstein, Div Med Practice, São Paulo, BrazilVirginia Commonwealth, Univ Sch Med, Dept Internal Med, Richmond, VA USAUniversidade Federal de São Paulo UNIFESP, Div Infect Dis, São Paulo, BrazilWeb of Science7engBiomed Central LtdBmc Infectious DiseasesCandidaBloodstream infectionTime to positivityAntifungal therapyTime to blood culture positivity as a predictor of clinical outcome in patients with Candida albicans bloodstream infectioninfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPORIGINALWOS000328901800001.pdfapplication/pdf197990${dspace.ui.url}/bitstream/11600/36879/1/WOS000328901800001.pdfd373a5e972e49b50ae75837b6ba34771MD51open accessTEXTWOS000328901800001.pdf.txtWOS000328901800001.pdf.txtExtracted texttext/plain29245${dspace.ui.url}/bitstream/11600/36879/2/WOS000328901800001.pdf.txtfd4097c9c64d821d4fd61f893abc31f4MD52open access11600/368792022-11-04 15:20:27.377open accessoai:repositorio.unifesp.br:11600/36879Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-05-25T12:29:02.518524Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Time to blood culture positivity as a predictor of clinical outcome in patients with Candida albicans bloodstream infection |
title |
Time to blood culture positivity as a predictor of clinical outcome in patients with Candida albicans bloodstream infection |
spellingShingle |
Time to blood culture positivity as a predictor of clinical outcome in patients with Candida albicans bloodstream infection Nunes, Cintia Zoya [UNIFESP] Candida Bloodstream infection Time to positivity Antifungal therapy |
title_short |
Time to blood culture positivity as a predictor of clinical outcome in patients with Candida albicans bloodstream infection |
title_full |
Time to blood culture positivity as a predictor of clinical outcome in patients with Candida albicans bloodstream infection |
title_fullStr |
Time to blood culture positivity as a predictor of clinical outcome in patients with Candida albicans bloodstream infection |
title_full_unstemmed |
Time to blood culture positivity as a predictor of clinical outcome in patients with Candida albicans bloodstream infection |
title_sort |
Time to blood culture positivity as a predictor of clinical outcome in patients with Candida albicans bloodstream infection |
author |
Nunes, Cintia Zoya [UNIFESP] |
author_facet |
Nunes, Cintia Zoya [UNIFESP] Marra, Alexandre Rodrigues [UNIFESP] Edmond, Michael B. Victor, Elivane da Silva Pereira, Carlos Alberto Pires [UNIFESP] |
author_role |
author |
author2 |
Marra, Alexandre Rodrigues [UNIFESP] Edmond, Michael B. Victor, Elivane da Silva Pereira, Carlos Alberto Pires [UNIFESP] |
author2_role |
author author author author |
dc.contributor.institution.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) Hosp Israelita Albert Einstein Virginia Commonwealth |
dc.contributor.author.fl_str_mv |
Nunes, Cintia Zoya [UNIFESP] Marra, Alexandre Rodrigues [UNIFESP] Edmond, Michael B. Victor, Elivane da Silva Pereira, Carlos Alberto Pires [UNIFESP] |
dc.subject.eng.fl_str_mv |
Candida Bloodstream infection Time to positivity Antifungal therapy |
topic |
Candida Bloodstream infection Time to positivity Antifungal therapy |
description |
Background: Few studies have assessed the time to blood culture positivity as a predictor of clinical outcome in fungal bloodstream infections (BSIs). the purpose of this study was to evaluate the time to positivity (TTP) of blood cultures in patients with Candida albicans BSIs and to assess its impact on clinical outcome.Methods: A historical cohort study with 89 adults patients with C. albicans BSIs. TTP was defined as the time between the start of incubation and the time that the automated alert signal indicating growth in the culture bottle sounded.Results: Patients with BSIs and TTPs of culture of <= 36 h (n = 39) and >36 h (n = 50) were compared. Septic shock occurred in 46.2% of patients with TTPs of <= 36 h and in 40.0% of patients with TTP of >36 h (p = 0.56). A central venous catheter source was more common with a BSI TTP of <= 36 h (p = 0.04). Univariate analyis revealed that APACHE II score >= 20 at BSI onset, the development of at least one organ system failure (respiratory, cardiovascular, renal, hematologic, or hepatic), SOFA at BSI onset, SAPS II at BSI onset, and time to positivity were associated with death. By using logistic regression analysis, the only independent predictor of death was time to positivity (1.04; 95% CI, 1.0-1.1, p = 0.035), with the chance of the patient with C. albicans BSI dying increasing 4.0% every hour prior to culture positivity.Conclusion: A longer time to positivity was associated with a higher mortality for Candida albicans BSIs; therefore, initiating empiric treatment with antifungals may improve outcomes. |
publishDate |
2013 |
dc.date.issued.fl_str_mv |
2013-10-20 |
dc.date.accessioned.fl_str_mv |
2016-01-24T14:34:35Z |
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2016-01-24T14:34:35Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
Bmc Infectious Diseases. London: Biomed Central Ltd, v. 13, 7 p., 2013. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/36879 http://dx.doi.org/10.1186/1471-2334-13-486 |
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1471-2334 |
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WOS000328901800001.pdf |
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10.1186/1471-2334-13-486 |
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WOS:000328901800001 |
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Bmc Infectious Diseases. London: Biomed Central Ltd, v. 13, 7 p., 2013. 1471-2334 WOS000328901800001.pdf 10.1186/1471-2334-13-486 WOS:000328901800001 |
url |
http://repositorio.unifesp.br/handle/11600/36879 http://dx.doi.org/10.1186/1471-2334-13-486 |
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eng |
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Biomed Central Ltd |
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Biomed Central Ltd |
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