| 著者 |
Ueda, Takashi
Kakeya, Hiroshi
Yoshida, Koichiro
Hisato, Akihiro
Ukimura, Akira
Ogawa, Taku
Nakajima, Kazuhiko
Iijima, Kosuke
Nagao, Miki
Tsuchido, Yasuhiro
Kawamura, Hideki
Shigemi, Akari
Hotomi, Muneki
Kono, Masamitsu
Kasahara, Kei
Imakita, Natsuko
Kaneko, Yukihiro
Niki, Makoto
Yamada, Koichi
Kakuno, Shigeki
宮崎, 泰可
WEKO
34876
| ja |
宮崎, 泰可
宮崎大学
|
| ja-Kana |
ミヤザキ, タイガ
|
| en |
Miyazaki, Taiga
University of Miyazaki
|
Search repository
住吉, 誠
WEKO
35239
e-Rad_Researcher
60965383
| ja |
住吉, 誠
宮崎大学
|
| ja-Kana |
スミヨシ, マコト
|
| en |
Sumiyoshi, Makoto
University of Miyazaki
|
Search repository
Murakami, Yasushi
Doi, Miki
Yoshioka, Mutsunobu
Miyazaki, Yoshitsugu
Takesue, Yoshio
|
|
内容記述 |
Background
A bedside scoring system to assess the severity of disease is lacking for candidaemia. The Pitt candidaemia score (PCS) was evaluated for its association with mortality.
Methods
The PCS consists of five components, namely dialysis, hypotension, mechanical ventilation, cardiac arrest and mental status. Patients were classified into four categories according to their PCS. The correlation between PCS category at blood culture collection and 30 day mortality was studied individually for five Candida species.
Results
Leading rates of mortality were observed in Candida tropicalis and Candida krusei. The interval from inoculation to positive culture was 19.4 ± 9.7 h for C. tropicalis and 21.3 ± 5.6 h for C. krusei; these intervals were significantly shorter than those for other Candida species. In a Kaplan–Meier survival curve, a significant risk stratification by PCS category was demonstrated in all Candida species. A high PCS was an independent risk factor for mortality, and source control decreased the risk for C. tropicalis and Candida glabrata infections. Regarding antifungal therapy, the median PCS was 8 for liposomal amphotericin B, 2 for echinocandins and 0 for azoles, and this trend was consistent among four Candida species.
Conclusions
The mortality rate was well stratified by the PCS, and the PCS affected the selection of antifungals. A future prospective study is required for the PCS in guiding therapy for candidaemia. |
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