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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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ORIGINAL ARTICLES  CARDIAC SECTION


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

lingua: Inglese

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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