Comparison of The Effect of Candida Score and Candida Colonization Index on Decrease in Candidemia Incidence in Our Intensive Care Unit

Abdullah Umut Pekok; Ahmet Yabalak; Sedef Tavukçu Özkan; Metin Kement; Mehmet Pekok; Berfin Sude Pekok

doi:10.19161/etd.1301169

Research Article

Yoğun Bakım Ünitemizde Candida Skoru ve Candida Kolonizasyon İndeksi'nin Kandidemi İnsidansındaki Azalmaya Etkisinin Karşılaştırılması

Year 2024, Volume: 63 Issue: 3, 383 - 389, 09.09.2024

Abdullah Umut Pekok , Ahmet Yabalak , Sedef Tavukçu Özkan , Metin Kement , Mehmet Pekok , Berfin Sude Pekok

https://doi.org/10.19161/etd.1301169

Abstract

Aim: Since candidemia is an important cause of mortality and morbidity in hospitals, especially in intensive care units (ICU), those hospitalized in the ICU; In patients with risk factors such as invasive device use and undergoing abdominal surgery, early empirical antifungal therapy is recommended to reduce mortality according to the results of candida score (CS) and candida colonization index (CCI). In this study, the data of the patients who were followed up in the ICU, who were started on empirical treatment according to KS and CCI, were evaluated and their effects on the incidence of candidemia were analyzed.
Method: Cultures taken from 100 patients hospitalized in the intensive care unit where adult patients were followed between 01.06.2018 and 01.08.2021 were examined. While investigating the colonization index of each patient, swab samples were taken once during the hospitalization from five main sites: mouth, nose, skin, perineum, and catheter. Samples taken with sterile swabs were inoculated on Sabouraud dextrose agar (SDA) plates and the plates were incubated at 35°C for 48 hours. The yeast colonies formed were defined according to their microscopic appearance and biochemical properties. CCI and CS of the patients were evaluated and fluconazole prophylaxis was started in patients with KS ≥3 or CCI ≥0.5.
Results: A total of 500 culture samples from 100 non-neutropenic adult patients were analyzed (Mean of 5 cultures/patient). No growth was detected in any of the samples in 32 (32 %) of 100 patients, and growth was detected in at least one of the samples taken from 68 patients (68 %). Reproduction was detected from a total of 118 samples. Of the yeasts, 104 were identified as Candida albicans, 10 as Candida glabrata and 4 as Candida inconspicua.
CS≥ 3 and CCI ≥0.5 in 11 (11%) patients, and CS≥3, CCI <0.5 in 12 (12%) patients, and a total of 23 (23%) patients were started on flucanozole prophylaxis. No patient developed candidemia during their follow-up
Conclusion: These findings suggest that the evaluation of patients followed in the ICU with CCI and CS, and initiation of prophylactic treatment in patients who are found to be at risk may be effective in preventing possible infections.

Keywords

Kandida kolonizasyon indeksi, kandida skoru, kandidemi insidansı, anti-fungal profilaksi

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