The Comparison Between Risk Factors of Invasive Candidiasis and 1,3-β-D-Glucan in Septic Pneumonia
DOI:
https://doi.org/10.36497/jri.v40i4.132Keywords:
1, 3-β-D-Glucan, sepsis, pneumonia, invasive candidiasis, risk factorsAbstract
Background: Invasive candidiasis (IC) occurs in immunocompromised and immunocompetent patients. It represents the 4th bloodstream infection in the ICU. Selection of patient characteristics based on risk factors in the 1,3-β-D-Glucan (BDG) examination provided a learning value in IC screening. The aim of this study was to assess the comparison of risk factors for IC and BDG levels using a cut off value of ≥80 pg/dl. Method: this cross-sectional study was conducted in 40 patients with septic pneumonia in ICU who had the risk factors of IC (multifocal colonization, broad-spectrum antibiotics, long term use of corticosteroids, and lymphocyte status) at Saiful Anwar Malang General Hospital. Results: There were 40 patients with risk factors of IC had positive BDG, but only 1 patient (2,5%) had candidemia and 14 patients (35%) had Candida sp from sputum culture. Comparison of BDG levels between group which used broad-spectrum antibiotics and those that did not wassignificant (P=0.020). Rank Spearman linear regression of the lymphocyte <1.200 cells/mm3 on BDG levels had a positive correlation (r=2.7%, P=0.880) while linear regression of the lymphocyte <1.200 cells/mm3 had a negative correlation (r=-32.1%, P=0.428). Conclusion: Septic pneumonia patients with Candida risk factors in the ICU might have superinfection with IC. The use of broad-spectrum antibiotics affected BDG levels more significant than other risk factors.Downloads
References
Antinori S, Milazzo L, Sollima S, Galli M, Corbellino M. Candidemia and invasive candidiasis in adults: A narrative review. Eur. J. Intern. Med. 2016;34:21-8.
Shamim S, Agarwal A, Ghosh BK, Mitra M. Fungal pneumonia in intensive care unit: when to suspect and decision to treatment: a critical review. J Assoc Chest Physicians. 2015;3(2):41.
Bongomin F, Gago S, Oladele R, Denning D. Global and multi-national prevalence of fungal diseases—estimate precision. J. Fungi. 2017;3(4):57.
Ahmed A, Azim A, Baronia AK, Marak KR, Gurjar M. Risk prediction for invasive candidiasis. Indian J Crit Care Med. 2014;18(10):682.
Mikulska M, Furfaro E, Viscoli C. Non-cultural methods for the diagnosis of invasive fungal disease. Expert Rev Anti Infect Ther. 2015;13(1):103-17.
Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung CL, Douglas IS, Jaeschke R, Osborn TM. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med. 2013;39(2):165-228.
Posteraro B, De Pascale G, Tumbarello M, Torelli R, Pennisi MA, Bello G, Maviglia R, Fadda G, Sanguinetti M, Antonelli M. Early diagnosis of candidemia in intensive care unit patients with sepsis: a prospective comparison of (1→ 3)-β-D-glucan assay, Candida score, and colonization index. Crit Care. 2011;15(5):R249.
PDPI. Pneumonia Komunitas. Pedoman Diagnosis dan Penatalaksanaan di Indonesia. Balai Penerbit FK UI. Jakarta. 2014.
Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801-10.
Kullberg BJ, Arendrup MC. Invasive candidiasis. N Engl J Med. 2015;373(15):1445-56.
Monneret G, Venet F, Kullberg BJ, Netea MG. ICU-acquired immunosuppression and the risk for secondary fungal infections. Med. Mycol.. 2011;49(Supplement_1):S17-23.
Martínez-Jiménez MC, Muñoz P, Valerio M, Alonso R, Martos C, Guinea J, et al. Candida biomarkers in patients with candidaemia and bacteraemia. J. Antimicrob. Chemother. 2015;70(8):2354-61.
Del Bono V, Delfino E, Furfaro E, Mikulska M, Nicco E, Bruzzi P, et al. Clinical performance of the (1, 3)-β-d-glucan assay in early diagnosis of nosocomial Candida bloodstream infections. Clin. Vaccine Immunol. 2011;18(12):2113-7.
Liss B, Cornely OA, Hoffmann D, Dimitriou V, Wisplinghoff H. 1, 3-β-d-Glucan contamination of common antimicrobials—authors' response. J. Antimicrob. Chemother. 2016;71(10):2997-9.
Lionakis MS, Kontoyiannis DP. Glucocorticoids and invasive fungal infection Lancet. 2003;362(9398):1828-38.
León C, Ruiz-Santana S, Saavedra P, Galván B, Blanco A, Castro C, Balasini C, Utande-Vázquez A, de Molina FJ, Blasco-Navalproto MA, López MJ. Usefulness of the “Candida score” for discriminating between Candida colonization and invasive candidiasis in non-neutropenic critically ill patients: a prospective multicenter study. Crit. Care Med. 2009;37(5):1624-33.
Migita K, Sasaki Y, Ishizuka N, Arai T, Kiyokawa T, Suematsu E, Yoshimura M, Kawabe Y, Matsumura R, Akagawa S, Mori S. Glucocorticoid therapy and the risk of infection in patients with newly diagnosed autoimmune disease. Medicine. 2013;92(5):285.
Badiee P, Zare M. Consideration of Invasive Fungal Infections in Immunocompetent Hosts. Arch. Clin. Infect. Dis. 2017;12(4).
Patterson TF, Donnelly JP. New Concepts in Diagnostics for Invasive Mycoses: Non-Culture-Based Methodologies. J. Fungi. 2019;5(1):9.
Koga M, Koibuchi T, Kikuchi T, Nakamura H, Miura T, Iwamoto A, et al. Kinetics of serum β-D-glucan after Pneumocystis pneumonia treatment in patients with AIDS. Intern. Med. J. 2011;50(13):1397-401.
Jaijakul S, Vazquez JA, Swanson RN, Ostrosky-Zeichner L. (1, 3)-β-D-glucan as a prognostic marker of treatment response in invasive candidiasis. Clin. Infect. Dis. 2012;55(4):521-6.
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