The epidemiology of Candida colonization and invasive candidiasis in a surgical intensive care unit where fluconazole prophylaxis is utilized: follow-up to a randomized clinical trial.

摘要: Objective To determine whether Candida glabrata colonization and invasive candidiasis (IC) increased among critically ill surgical patients 3 years after the introduction of fluconazole prophylaxis to a intensive care unit (SICU). Summary background data Fluconazole has been shown in randomized clinical trials reduce occurrence some patient populations, including high-risk SICU patients. One such trial was performed The Johns Hopkins Hospital 1998. Whether epidemiology IC changed SICUs where is routinely utilized not adequately studied. Methods We conducted prospective, observational study subjects admitted for > or = days large, urban, academic medical center, had approximately years. Surveillance fungal cultures rectal/fecal swabs, urine, endotracheal aspirates were on admission SICU, once weekly, upon discharge from SICU. Demographic collected. C. prevalence prospective cohort compared with enrolled 1998 prevention that at same institution. Results significantly more common 2003 as (adjusted odds ratio [OR]: 0.90, 95% confidence interval [CI]: 0.57-1.41). Patients likely than those have due OR: 1.93, CI: 0.20-18.98), while less acquired ICU 0.08, 0.009-0.82). Conclusions There no increase proportion 3-year period routine selected