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The Journal of Cardiovascular Surgery 2001 June;42(3):339-43

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Predictive value of Candida colonization index in 131 patients undergoing two different cardiovascular surgical procedures

Yazdanparast K., Auger P., Marchand R., Carrier M., Cartier R.

From the Department of Microbiology Montreal Heart Institute, Quebec, Canada


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Background. Nosocomial can­di­de­mia is an impor­tant infec­tion ­because of ­its increas­ing inci­dence ­and ­its ­high fatal­ity ­rate. Candidiasis ­involves mul­ti­ple ­risk fac­tors. In ­this ­work, we ­study ­the ­degree of Candida col­o­ni­za­tion in car­di­o­vas­cu­lar sur­gi­cal ­patients by tak­ing ­into ­account ­the num­ber of ­sites col­o­nized ­and ­the den­sity of ­growth.
Methods. Eleven (11) select­ed var­i­ables (­age, ­sex, ­weight, dia­betes, num­ber of anti­bi­o­tics, dura­tion of anti­bi­o­tics, ­length of hos­pi­tal­iza­tion, ­length of ­stay in sur­gi­cal inten­sive ­care ­unit, dura­tion of sur­gery, tem­per­a­ture dur­ing sur­gery, ­and num­ber of ­bypass) ­were con­sid­ered to pre­dict ­the per­i­op­er­a­tive vari­a­tion of ­the col­o­ni­za­tion ­index (CI) by Candida in 131 car­di­o­vas­cu­lar sur­gi­cal ­patients. These ­patients ­were divid­ed ­into ­two ­groups: ­group A, cor­o­nary ­artery ­bypass graft­ing ­with extra­cor­po­real cir­cu­la­tion (72 ­patients) ­and ­group B, cor­o­nary ­artery ­bypass graft­ing with­out extra­cor­po­real cir­cu­la­tion (59 ­patients).
Results. One thousand and forty-eight fun­gal cul­tures ­were ­obtained ­from ­four dif­fer­ent ­body ­sites ­and 162 iso­lat­ed ­were iden­ti­fied. Candida albi­cans account­ed ­for 74% of ­the ­strains in ­group A ­and 97% in ­group B. The sta­tis­ti­cal anal­y­sis (­two-­way ano­va) ­shows ­that ­group A ­patients ­with an ­increased CI ­have ­received sig­nif­i­cant­ly ­more anti­bi­o­tics ­than ­those ­with a ­stable CI (1.50±0.83 vs 1.08± 0.40, p=0.0055).
Conclusions. Epidemiological ­data ­obtained ­from ­this ­study ­show ­that cor­o­nary ­artery ­bypass graft­ing ­with extra­cor­po­real cir­cu­la­tion pro­ce­dure is asso­ciat­ed ­with an ­increase in ­the ­use of anti­bi­o­tics ­and sub­se­quent­ly a high­er ­risk a Candida col­o­ni­za­tion-infec­tion.

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