Risk Factors for Hospital-Acquired Candidemia: A Matched Case-Control Study

Sergio B. Wey, Motomi (Tomi) Mori, Michael A. Pfaller, Robert F. Woolson, Richard P. Wenzel

Research output: Contribution to journalArticle

553 Citations (Scopus)

Abstract

Nosocomial candidemia has become an important infection not only because of an apparently increasing incidence but also because of its high fatality rate. We studied 28 risk factors through a matched case-control study that included 88 pairs of patients hospitalized between July 1983 and December 1986. The strongest single risk factor found in the univariate analysis was the number of prior antibiotics administered: the exposure odds ratio (OR) was 12.50 when patients who received three to five antibiotics were compared with those who received none to two antibiotics. A multiple logistic regression analysis using a conditional likelihood method was performed to evaluate several risk factors simultaneously. The final model selected by a stepwise procedure Included the following variables: number of antibiotics received prior to infection (OR, 1.73 per unit increase), isolation of Candida species from sites other than blood (OR, 10.37), prior hemodialysis (OR, 18.13), and prior use of a Hickman catheter (OR, 7.23). It remains to be shown in controlled clinical trials whether limiting the number of antibiotics or instituting prophylaxis and/or early treatment for high-risk patients will reduce the incidence of nosocomial candidemia.

Original languageEnglish (US)
Pages (from-to)2349-2353
Number of pages5
JournalArchives of Internal Medicine
Volume149
Issue number10
DOIs
StatePublished - 1989
Externally publishedYes

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Candidemia
Case-Control Studies
Odds Ratio
Anti-Bacterial Agents
Incidence
Controlled Clinical Trials
Infection
Candida
Renal Dialysis
Catheters
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Risk Factors for Hospital-Acquired Candidemia : A Matched Case-Control Study. / Wey, Sergio B.; Mori, Motomi (Tomi); Pfaller, Michael A.; Woolson, Robert F.; Wenzel, Richard P.

In: Archives of Internal Medicine, Vol. 149, No. 10, 1989, p. 2349-2353.

Research output: Contribution to journalArticle

Wey, Sergio B. ; Mori, Motomi (Tomi) ; Pfaller, Michael A. ; Woolson, Robert F. ; Wenzel, Richard P. / Risk Factors for Hospital-Acquired Candidemia : A Matched Case-Control Study. In: Archives of Internal Medicine. 1989 ; Vol. 149, No. 10. pp. 2349-2353.
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