論文

査読有り 国際誌
2018年10月

Prevalence of, and risk factors for, hematogenous fungal endophthalmitis in patients with Candida bloodstream infection.

Infection
  • Hideaki Kato
  • ,
  • Yukihiro Yoshimura
  • ,
  • Yoshihiro Suido
  • ,
  • Kazuo Ide
  • ,
  • Yoshifumi Sugiyama
  • ,
  • Kasumi Matsuno
  • ,
  • Hideaki Nakajima

46
5
開始ページ
635
終了ページ
640
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s15010-018-1163-z
出版者・発行元
Urban und Vogel GmbH

PURPOSE: Endogenous fungal endophthalmitis (EFE) is a severe consequence of candidemia. The prevalence of, and risk factors for, EFE is not well studied. METHODS: We retrospectively collected cases of patients with candidemia who had undergone ophthalmological examination between April 2011 and March 2016 in five regional hospitals. We conducted bivariate and multivariate analyses using patients' age, gender, causative Candida species, diabetes status, corticosteroid use, cancer status, neutropenia, intensive care unit admission, presence of central venous catheter (CVC), presence of shock, prior antibiotic use, 30-day mortality, and highest Sequential Organ Failure Assessment (SOFA) score. Data on sustained positive blood culture, β-D glucan, CVC removal, empirical antifungal drug used, and time to appropriate antifungal therapy were also collected if available. RESULTS: Of 174 patients with candidemia, 35 (20.1%) were diagnosed with EFE, including 31 (17.8%) with chorioretinitis and 4 (2.3%) with vitritis. Bivariate analysis (EFE group vs. non-EFE group) found that Candida albicans candidemia (77.1 vs. 34.5%, P < 0.001), neutropenia (14.3 vs. 5.8%, P = 0.141), CVC placement (94.3 vs. 71.2%, P = 0.004), and the presence of shock (28.6 vs. 16.5%, P = 0.145) were each higher in the EFE group. Multivariate logistic regression analysis found C. albicans candidemia (adjusted odds ratio 6.48; [95% CI 2.63-15.95]) and CVC placement (7.55 [1.56-36.53]) to be significant risk factors for EFE. CONCLUSIONS: Candida albicans is the most common causative agent for Candida EFE. Patients with candidemia and CVC placement should be closely monitored by ophthalmologists.

リンク情報
DOI
https://doi.org/10.1007/s15010-018-1163-z
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/29959658
ID情報
  • DOI : 10.1007/s15010-018-1163-z
  • ISSN : 1439-0973
  • ISSN : 0300-8126
  • PubMed ID : 29959658
  • SCOPUS ID : 85049122712

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