398. Risk Factors Associated with Requiring Invasive Mechanical Ventilation in Patients with SARS-CoV-2 Infection: Experience in a Tertiary Care Hospital in Mexico City

Abstract Background The clinical presentation of SARS-CoV-2 disease ranges from asymptomatic respiratory infection to acute respiratory distress syndrome. Risk factors upon hospital admission associated with the need for invasive mechanical ventilation are not well documented. Methods 185 hospitalized patients with confirmed COVID-19 were enrolled in this study, and they were classified as patients who required invasive mechanical ventilation and patients who did not require it. Comorbidities such as diabetes, high blood pressure, obesity, chronic lung disease and immunodeficiency were recorded. Laboratory studies were requested upon admission such as C-reactive protein, leukocyte and lymphocyte levels, D-dimer, troponin, serum ferritin and procalcitonin. Results Of the patients who entered the study, 65 patients (35%) required invasive mechanical ventilation (IMV), while 120 (65%) did not require advanced airway management. Of the patients with invasive mechanical ventilation, age > 65 years, male sex, obesity (BMI > 30) and high blood pressure were the most frequent characteristics, presenting the latter two in 26% and 27% respectively. Regarding laboratory studies, the parameters most associated with the requirement for mechanical ventilation were a D-dimer (> 1000) and troponin (> 1), with 26% and 18%, respectively. Conclusion This study showed the high proportion of obesity, hypertension and advanced age among patients who required invasive mechanical ventilation associated with SARS-CoV2 infection. The presence of elevated D-dimer and troponin on admission are associated with more severe presentations and a requirement for invasive mechanical ventilation. Disclosures All Authors: No reported disclosures

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Period prevalence of hypertension and risk factors in an urban slum of Maharashtra

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20192862 ◽

2019 ◽

Vol 6 (7) ◽

pp. 3123

Author(s):

Ajinkya J. J. Niwal ◽

Muralidhar P. Tambe ◽

S. P. Rao ◽

Malangori A. Parande

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

High Blood Pressure ◽

Tertiary Care ◽

Public Health Problem ◽

Urban Slum ◽

Behavioral Risk ◽

Care Hospital ◽

Hypertensive Patients ◽

Cooked Food

Background: One in three adults worldwide has high blood pressure and proportion increases with age. Detecting high blood pressure is easy. Hence a study for prevalence of hypertension was conducted in an urban slum of Pune, Maharashtra.Methods: The study was conducted in an urban slum field practice area exclusively under the community medicine department of a tertiary care hospital during the period of February 2014- July 2014. Overall 1043 people fulfilling the inclusion and exclusion criteria were interviewed, and anthropometric measurements were taken, followed by blood pressure readings and awareness of own hypertensive status. Data was compiled, edited, classified, and analyzed. The prevalence of hypertensive patients was obtained and physical and behavioral risk factors were analyzed for association.Results: The prevalence of hypertension in adults above 18 years of age was 25.6% with mean age of hypertensive patients was 48.58±15.75 yrs. Hypertension was significantly associated with age, habit of adding extra salt to cooked food, family history, BMI and consumption of smokeless form of tobacco among the study participants. Hypertension was not significantly associated with gender and religion of the participants. Of the 267 hypertensives, 40.82% were aware of their hypertensive status and amongst those aware 61.46% were on anti-hypertensives.Conclusions: Hypertension is a public health problem affecting slum population as well. It is significantly associated with risk factors, which are modifiable. The awareness of hypertensive status is low, the under treatment is lower. The population in slum, with its poor literacy, low awareness and income levels provides an opportunity to make an intervention necessary as well as challenging.

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Prognostic factors and outcome of Post-Neonatal Tetanus in an intensive care unit of a Tertiary Care Hospital

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.5.656 ◽

2019 ◽

Vol 35 (5) ◽

Author(s):

Nighat Sultana ◽

Attia Bari ◽

Mehwish Faizan ◽

Muhammad Sarwar

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Prognostic Factors ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Neonatal Tetanus ◽

P Value ◽

Care Hospital

Objective: To determine the prognostic factors and outcome of tetanus in children of post-neonatal age admitted in the intensive care unit (ICU) of a tertiary care hospital. Methods: This prospective cross sectional study, carried out in the Pediatric ICU of The Children’s Hospital Lahore from Jan 2013 to March 2017. Children of both genders with age range of two months to 16 years diagnosed clinically as tetanus were included. All 132 patients were scrutinized for all possible risk factors, need for mechanical ventilation and outcome. Data was analyzed by SPSS version 20. Results: Mean age of children was 7.5±3.4 years with male predominance (70.5%). Only (38.6%) received three doses of vaccination but none had booster dose. Trauma (43.2%) encompassed maximum predisposing factor followed by ear or nose prick and ear discharge. Mean duration of ICU stay was 20±13.3 days. Mortality rate was (17.4%). Ventilator support was given to (78.8%). Neurological outcome was normal in (82.6%). Trauma, ear or nose prick in girls and ear discharge were significantly associated with poor outcome and death with p-value of <0.001, 0.011 and <0.001 respectively. Other factors associated with poor outcome were need for mechanical ventilation and neurological impairment with p-value of 0.001 and <0.001 respectively. Conclusion: Tetanus is causing our children to suffer from devastating disease. Vaccination status is not satisfactory and along with trauma, ear discharge and ear or nose prick are identifiable risk factors. To combat these issues large scale vaccination and booster doses remains promising option. doi: https://doi.org/10.12669/pjms.35.5.656 How to cite this:Sultana N, Bari A, Faizan M, Sarwar M. Prognostic factors and outcome of Post-Neonatal Tetanus in an intensive care unit of a Tertiary Care Hospital. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.656 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Acute kidney injury in patients with severe COVID-19 in Mexico

10.1101/2020.08.28.20167379 ◽

2020 ◽

Author(s):

GUSTAVO CASAS ◽

MARIA-ISABEL LEON ◽

MAURICIO GONZALEZ-NAVARRO ◽

CLAUDIA ALVARADO DE LA BARRERA ◽

Santiago Avila-Rios ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Acute Kidney Injury ◽

Serum Creatinine ◽

Systemic Disease ◽

Invasive Mechanical Ventilation ◽

Laboratory Data ◽

Kidney Injury ◽

Vasoactive Drugs ◽

D Dimer

Introduction: Some patients with COVID-19 pneumonia present systemic disease involving multiple systems. There is limited information about the clinical characteristics and events leading to acute kidney injury (AKI). We described the factors associated with the development of AKI and explored the relation of AKI and mortality in Mexican population with severe COVID-19. Methods: We retrospectively reviewed the medical records of individuals with severe pneumonia caused by SARS-CoV-2 hospitalized at the largest third-level reference institution for COVID-19 care in Mexico between March and April 2020. Demographic information, comorbidities, clinical and laboratory data, dates of mechanical ventilation and hospitalization, mechanical-ventilator settings and use of vasoactive drugs were recorded. Results: Of 99 patients studied, 58 developed AKI (58.6%). The group with AKI had higher body mass index (p=0.0003) and frequency of obesity (p=0.001); a higher requirement of invasive mechanical ventilation (p=0.008) and vasoactive drugs (p=0.004); greater levels of serum creatinine (p<0.001) and D-dimer on admission (p<0.001); and lower lymphocyte counts (p=0.001) than the non-AKI group. The multivariate analysis indicated that risk factors for AKI were obesity (adjusted hazard ratio (HR)=2.71, 95% confidence interval (CI)=1.33-5.51, p=0.005); higher serum creatinine (HR=1.44, CI=1.02-2.02, p=0.035) and D-dimer levels on admission (HR=1.14, CI=1.06-1.23, p<0.001). In-hospital mortality was higher in the AKI group than in the non-AKI group (65.5% vs. 14.6%; p=0.001). Conclusions: AKI was common in our cohort of patients with severe COVID-19 and it was associated with mortality. The risk factors for AKI were obesity, elevated creatinine levels and higher D-dimer levels on admission. Key words: Acute kidney injury; AKI; acute renal failure; COVID-19; SARS-CoV-2.

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Clinical Profile, Outcome and Risk Factors for Mortality of Neonates Requiring Mechanical Ventilation at Tertiary Care Centre of Central Gujarat, India

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v41i1.30630 ◽

2021 ◽

Vol 41 (1) ◽

pp. 29-34

Author(s):

Pareshkumar A Thakkar ◽

Himanshu G Pansuriya ◽

Sheela Bharani ◽

Khushboo Kamal Taneja

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Tertiary Care ◽

Pulmonary Haemorrhage ◽

Adverse Outcomes ◽

Clinical Profile ◽

Care Hospital

Introduction: Mechanical ventilation is an important factor contributing to the reduced neonatal mortality in NICU. However, many ventilated babies are left with detrimental sequelae. This study was undertaken to know the prognostic predictors and survival outcome in the ventilated neonates. We assessed the clinical profile, outcome of mechanical ventilation and analysed the risk factors for mortality and complications resulting from mechanical ventilation. Methods: A prospective study was conducted at the NICU of a tertiary care hospital in India. The study period was from May 2015 to April 2016. Neonates who underwent mechanical ventilation and met the inclusion criteria were enrolled in the study. Their demographic profile, outcomes and risk factors were documented and analysed using appropriate statistical methods. Results: 285 neonates required mechanical ventilation during the study period. Among them, 190 were included in the study. Overall mortality was 99 out of the 190 enrolled (52%). The most common indications for mechanical ventilation were Respiratory Distress Syndrome (RDS), Meconium Aspiration Syndrome (MAS) and apnea. Risk factors contributing significantly to higher mortality of ventilated neonates were very low birth weight (VLBW), gestation of less than 32 weeks, shock, ventilator- associated complications like pneumothorax and pulmonary haemorrhage. In multiple regression analysis, very low birth weight, circulatory disturbances, pneumothorax, pulmonary haemorrhage, and higher initial FiO2 requirement were found to be independent risk factors of mortality. Conclusions: The commonest indications for mechanical ventilation were RDS and MAS. Significantly higher mortality was seen amongst VLBW, preterm neonates. Co-morbidities like circulatory disturbance, and complications like pneumothorax and pulmonary haemorrhage contributed to adverse outcomes.

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Awareness of Risk factor and Warning symptoms of Stroke among patients with hypertension at Tertiary care hospital of South India

Research Journal of Pharmacy and Technology ◽

10.52711/0974-360x.2021.01003 ◽

2021 ◽

pp. 5769-5774

Author(s):

K. Sathiya ◽

P. Vijayasamudeeswari ◽

R. Poongodi

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Blood Pressure ◽

Risk Factor ◽

High Blood Pressure ◽

Good Knowledge ◽

Care Hospital ◽

Poor Knowledge ◽

Hypertensive Patients ◽

Structured Questionnaire

Introduction: High blood pressure, also termed as hypertension is a condition that afflicts almost 1 billion people worldwide and is a leading cause of mortality and morbidity. Therefore, this disease is often referred as a “Silent Killer.” In most of the instances, this disease remains asymptomatic until severe to express as one of the following outcomes: stroke, myocardial infarction, renal dysfunction, visual problems and others. Thus, hypertension is affirmed as the major risk factor for stroke, coronary artery disease and myocardial infarction. High blood pressure is one of the most common causes of stroke as it strains blood vessel walls causing them to thicken and deteriorate. Aim: To Assess the awareness of risk factors, symptoms of stroke among hypertensive patients and associate the awareness of risk factors and symptoms stroke with selected variables. Methods: a non-experimental descriptive research design was used in this study. the study was conducted among 300 samples of all the hypertensive patients admitted in Sri Ramachandra hospital and the patients who come for OPD during the study period. Purposive sampling technique is used for the study. The instrument used for this study has 3 components demographic data, self structured questionnaire on risk factors of stroke and self structured questionnaire on symptoms of stroke. Data were collected and analyzed using descriptive and inferential statistics. Findings: With related symptoms severity reveals that majority of the sample 220(73.3%) had poor knowledge and 58(19.3%) had moderate knowledge and 4(1.3%) had good knowledge risk factors Reveals that majority of the sample 156 (52.0%) had poor knowledge and 109(36.3%) had poor knowledge 109 (36.3%) had moderate knowledge and 10(3.3%) had good knowledge. The mean and standard deviation of awareness of risk factors and symptoms of stroke among patient with hypertension was and there was no significant association between any patient with hypertension and selected demographic variables. Conclusion: The study concluded that majority of the samples had poor knowledge on risk factors and symptoms of stoke among hypertensive patients. Here the health care team members need create awareness among public in order reduce the morbidity and mortality rate of stroke.

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Extracorporeal membrane oxygenation for COVID-19 induced hypoxia: Single-center study

Perfusion ◽

10.1177/0267659120963885 ◽

2020 ◽

pp. 026765912096388

Author(s):

Muhtadi Alnababteh ◽

Muhammad D Hashmi ◽

Karthik Vedantam ◽

Rajus Chopra ◽

Akshay Kohli ◽

...

Keyword(s):

Mechanical Ventilation ◽

Extracorporeal Membrane Oxygenation ◽

Invasive Mechanical Ventilation ◽

Tertiary Care ◽

Conventional Mechanical Ventilation ◽

Washington Dc ◽

Clinical Prognosis ◽

Membrane Oxygenation ◽

Scientific Challenge ◽

D Dimer

Introduction: The pandemic of the coronavirus disease 2019 (COVID-19) and associated pneumonia represent a clinical and scientific challenge. The role of Extracorporeal Membrane Oxygenation (ECMO) in such a crisis remains unclear. Methods: We examined COVID-19 patients who were supported for acute respiratory failure by both conventional mechanical ventilation (MV) and ECMO at a tertiary care institution in Washington DC. The study period extended from March 23 to April 29. We identified 59 patients who required invasive mechanical ventilation. Of those, 13 patients required ECMO. Results: Nine out of 13 ECMO (69.2%) patients were decannulated from ECMO. All-cause ICU mortality was comparable between both ECMO and MV groups (6 patients [46.15%] vs. 22 patients [47.82 %], p = 0.92). ECMO non-survivors vs survivors had elevated D-dimer (9.740 mcg/ml [4.84-20.00] vs. 3.800 mcg/ml [2.19-9.11], p = 0.05), LDH (1158 ± 344.5 units/L vs. 575.9 ± 124.0 units/L, p = 0.001), and troponin (0.4315 ± 0.465 ng/ml vs. 0.034 ± 0.043 ng/ml, p = 0.04). Time on MV as expected was significantly longer in ECMO groups (563.3 hours [422.1-613.9] vs. 247.9 hours [101.8-479] in MV group, p = 0.0009) as well as ICU length of stay 576.2 hours [457.5-652.8] in ECMO group vs. 322.2 hours [120.6-569.3] in MV group, p = 0.012). Conclusion: ECMO is a supportive intervention for COVID-19 associated pneumonia that could be considered if the optimum mechanical ventilation is deemed ineffective. Biomarkers such as D-dimer, LDH, and troponin could help with discerning the clinical prognosis in patients with COVID-19 pneumonia.

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SARS-CoV-2 RNAemia with higher nasopharyngeal viral load is strongly associated with severity and mortality in patients with COVID-19

10.1101/2020.12.17.20248388 ◽

2020 ◽

Author(s):

Hitoshi Kawasuji ◽

Yoshitomo Morinaga ◽

Hideki Tani ◽

Yoshihiro Yoshida ◽

Yusuke Taekgoshi ◽

...

Keyword(s):

Mechanical Ventilation ◽

Critically Ill ◽

Invasive Mechanical Ventilation ◽

Tertiary Care ◽

Clinical Severity ◽

Care Hospital ◽

Oxygen Supplementation ◽

Cross Sectional ◽

Icu Admission ◽

Viral Loads

AbstractObjectiveThis study aimed to determine the frequency of SARS-CoV-2 RNA in serum and its association with the clinical severity of COVID-19.MethodsAn analytical cross-sectional study was performed in a single tertiary care hospital and included consecutive patients with confirmed COVID-19. The prevalence of SARS-CoV-2 RNAemia and the strength of its association with clinical severity variables, including required oxygen supplementation, ICU admission, invasive mechanical ventilation, and in-hospital mortality, were examined.ResultsFifty-six patients were included in the study. The median age was 54.5 years, and individuals with RNAemia were older than those without detectable SARS-CoV-2 RNA in serum (78 vs. 50 years; P = .0013). RNAemia was detected in 19.6% of patients (11/56) and in 1.0% (1/25), 50.0% (6/12), and 100.0% (4/4) of moderate, severe, and critically ill cases, respectively. Patients with RNAemia required more frequent oxygen supplementation (90.0% vs. 13.3%; P < .0001) and ICU admission (81.8% vs. 6.7%; P < .0001) and required invasive mechanical ventilation (27.3% vs. 0.0%; P < .0001). Among patients with RNAemia, the median viral loads of NP swabs that were collected around the same time as the serum were significantly higher in critically ill cases (5.4 Log10 copies/μL [IQR: 4.2–6.3]) than in moderate–severe cases (2.6 Log10 copies/μL [1.1–4.5]; P =.030) and were significantly higher in nonsurvivor cases (6.2 Log10 copies/μL [IQR: 6.0–6.5]) than in survivor cases (3.9 Log10 copies/μL [1.6–4.6]; P =.045).ConclusionsThis study demonstrated a relatively high proportion of SARS-CoV-2 RNAemia and an association between RNAemia and clinical severity. Moreover, among the patients with RNAemia, the viral loads of NP swabs were correlated with severity and mortality, thus suggesting the potential utility of combining serum testing with NP tests as a prognostic indicator for COVID-19 with a higher quality than each separate test.

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Ventilator associated pneumonia: incidence and risk factors in a tertiary care hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20190741 ◽

2019 ◽

Vol 6 (2) ◽

pp. 848

Author(s):

Manish Rathor ◽

Neetu Sharma

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Risk Factor ◽

Late Onset ◽

Tertiary Care ◽

Polymorphonuclear Cells ◽

Ventilator Associated Pneumonia ◽

Care Hospital ◽

Altered Sensorium ◽

Associated Risk Factors

Background: The objective of this study is to find the occurrence and contributing risk factor of ventilator associated pneumonia (VAP) in 2 months-5 years age group.Methods: This was a prospective, observational, hospital-based study carried out in a tertiary care setting hospital. All patients between 2 months-5 years age admitted in the ICU who had undergone MV were included in the study. Inclusion criteria includes patients who developed pneumonia after the 48 hours of mechanical ventilation and those patients were excluded who developed pneumonia within 48 hours of mechanical ventilation and having respiratory system findings /involvement prior to the MV. After recruiting patients baseline clinical characteristics (age, sex, diagnosis, duration of MV) were taken, monitored and diagnosed VAP using CDC guidelines until they were discharged or deceased. The parameters such as fever, oxygenation, leucocytosis, other risk factors. chest X-ray and ETA>105CFU/ML or microscopy (grain stain>l bacteria/>10 polymorphonuclear cells) were collected every 48 hours.Results: This study was done in 133 patients while 42 patients (31.58%) developed VAP during their ICU stay. Early onset VAP occurred in 34 (80.9%) while late onset VAP was observed in the remaining 8 (19.1%) patients. In ETA culture CFU>105 Klebsiella (38%) was the predominant isolate followed by Pseudomonas (23%), Acinetobacter (17%), Staphylococcus (13%) and Citrobacter (10%) are offending organism responsible for VAP in MV patient in present study. On analysis (univariate) reintubation, altered sensorium at intubation and use of antacid are found significantly associated risk factors with the development of VAP. Multivariate analysis revealed that reintubation was an important risk factor for the development of the VAP.Conclusions: The various risk factors can be minimized for better outcome of patients undergoing mechanical ventilation. Risk factors such as reintubation, altered sensorium at intubation and use of antacid are associated with VAP and also the physician treating must have knowledge and awareness about prevention of these risk factor to improve the outcome of patients.

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Factors associated with progression to critical illness in 28 days among COVID-19 patients: results from a tertiary care hospital in Istanbul, Turkey

10.1101/2020.10.09.20209775 ◽

2020 ◽

Author(s):

Uluhan Sili ◽

Pinar Ay ◽

Ahmet Topuzoglu ◽

Huseyin Bilgin ◽

Elif Tukenmez Tigen ◽

...

Keyword(s):

Mechanical Ventilation ◽

Critical Illness ◽

Tertiary Care Hospital ◽

Invasive Mechanical Ventilation ◽

Tertiary Care ◽

Multivariable Analysis ◽

Cox Proportional Hazards ◽

Care Hospital ◽

Laboratory Findings ◽

Presenting Symptoms

ABSTRACTBackgroundCoronavirus disease 2019 (COVID-19) quickly spread worldwide to become a pandemic. This study aimed to define the predictors of critical illness development within 28 days postadmission.MethodsWe conducted a prospective cohort study including 477 PCR-positive COVID-19 patients admitted to a tertiary care hospital in Istanbul from March 12 to May 12, 2020. The development of critical illness, e.g., invasive mechanical ventilation and/or death, was followed for a period of 28 days postadmission. Demographic characteristics, number of comorbidities, illness severity at admission defined by the WHO scale, vital signs, laboratory findings and period of admission to the hospital were independent variables. Cox proportional hazards analysis was performed, and the C-index was calculated.ResultsThe median (IQR) age of the cohort was 55.0 (44.0-67.0) years, and 50.1% were male. The most common presenting symptoms were cough, dyspnea and fatigue. Overall, 65.2% of the patients had at least one comorbidity. Hydroxychloroquine was given to 99.2% of the patients. Critical illness developed in 45 (9.4%; 95% CI: 7.0%-12.4%) patients. In the multivariable analysis, age (HR: 1.05, p<0.001), number of comorbidities (HR: 1.33, p=0.02), procalcitonin ≥0.25 µg/L (HR: 2.12, p=0.03) and LDH ≥350 U/L (HR: 2.04, p=0.03) were independently associated with critical illness development. The WHO scale on admission was the strongest predictor of critical illness (HR: 4.15, p<0.001). Prognosis improved within the study period (p<0.05). The C-index of the model was 0.92.ConclusionsAge, comorbidity number, WHO scale, LDH and procalcitonin were independently associated with critical illness development. Mortality from COVID-19 seems to be decreasing as the pandemic advances.summaryWe analyzed 477 confirmed COVID-19 patients for the development of critical illness, e.g., invasive mechanical ventilation and/or death within 28 days postadmission. Age, comorbidity number, WHO scale, LDH and procalcitonin were independently associated with critical illness development.

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Epidemiology of Candidemia: Three-Year Results from a Croatian Tertiary Care Hospital

Journal of Fungi ◽

10.3390/jof7040267 ◽

2021 ◽

Vol 7 (4) ◽

pp. 267

Author(s):

Ivana Mareković ◽

Sanja Pleško ◽

Violeta Rezo Vranješ ◽

Zoran Herljević ◽

Tomislav Kuliš ◽

...

Keyword(s):

Risk Factors ◽

Tertiary Care Hospital ◽

Invasive Mechanical Ventilation ◽

Tertiary Care ◽

Bloodstream Infections ◽

Venous Catheter ◽

Control Measures ◽

University Hospital ◽

Care Hospital ◽

Infection Control Measures

Invasive candidosis is the most common invasive fungal infection in hospitalized patients and is associated with a high mortality rate. This is the first study from a Croatian tertiary care hospital describing epidemiology, risk factors and species distribution in patients with candidemia. A three-year retrospective observational study, from 2018 to 2020, was performed at the University Hospital Centre Zagreb, Zagreb, Croatia. A total of 160 patients with candidemia (n = 170 isolates) were enrolled. Candidemia incidence increased from 0.47 to 0.69 per 1000 admissions in 2018 and 2020, respectively. Ninety-five patients (58.38%) were in the intensive care unit. The main risk factors for candidemia were central venous catheter (CVC) (84.38%), previous surgical procedure (56.88%) and invasive mechanical ventilation (42.50%). Candida albicans was identified in 43.53% of isolates, followed by C. parapsilosis (31.76%) and C. glabrata (12.36%), C. krusei (5.29%), C. tropicalis (2.35%) and C. lusitaniae (2.35%). The study discovered a shift to non-albicansCandida species, particularly C. parapsilosis, and made it possible to determine the main tasks we should focus on to prevent candidemia in the hospital, these being mainly infection control measures directed towards prevention of catheter-related bloodstream infections, specifically comprising hand hygiene and CVC bundles of care. The potential benefit of fluconazole prophylaxis in certain populations of surgical patients could also be considered.

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