scholarly journals 1702. Prevalence and Risk Factors for Endogenous Fungal Endophthalmitis in Adult Patients with Candidemia at a Tertiary Care Hospital in South Korea Over 13 years

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S623-S623
Author(s):  
Jong Hun Kim ◽  
Jin Woong Suh ◽  
You Seung Chung ◽  
Young Kyung Yoon ◽  
Jang Wook Sohn ◽  
...  

Abstract Background Endogenous fungal endophthalmitis is one of the critical complications of candidemia in adult patients. We conducted a study to investigate the prevalence and risk factors for endogenous fungal endophthalmitis in adult patients with candidemia. Methods Adult patients ≥19 years with candidemia who underwent ophthalmological examination after the diagnosis of candidemia at a tertiary care hospital in South Korea from 2006 to 2018 were enrolled, and clinical data were collected. Results There was a total of 152 adult patients with candidemia who underwent an ophthalmological examination. Endogenous fungal endophthalmitis was found in 29 patients (19.1%). Patients were categorized into two groups (Non-endophthalmitis [NE] and endophthalmitis [E]). Between two groups, there was no significant difference in terms of age, sex, underlying comorbidities. Also, no difference in clinical conditions at the diagnosis of candidemia was noted including concomitant bacteremia, presence of septic shock, receipt of recent surgery, presence of neutropenia, total parenteral nutrition, central venous catheter, urinary catheter, ventilator, dialysis, use of antibiotics, and Candida spp. colonization. However, there was a higher rate of abnormal alanine aminotransferase (ALT) in the E (35.7%) than in the NE (14.8%), P = 0.008. Moreover, the proportion of C. albicans candidemia was higher in the E (65.5%) than in the NE (35.8%), P = 0.003. In contrast, C. parapsilosis candidemia was more common in the NE (27.6%) than in the E (6.9%), P = 0.018. Although there was a trend of higher mortality rate in the E (51.7%) than in the NE (35.0%), no statistical significance was observed, P = 0.095. Multivariate logistic analysis showed C. albicans candidemia (odds ratio [OR] 4.122, 95% confidence interval [CI] 1.653–10.280, P = 0.002) and abnormal ALT (OR 3.839, 95% CI 1.427–10.333, P = 0.008) were significantly associated with E cases. Conclusion Endogenous fungal endophthalmitis occurred in 19% of adult patients with candidemia. C. albicans candidemia and abnormal ALT were significantly associated with endophthalmitis. Adult patients with candidemia caused by C. albicans or having abnormal ALT need to be closely monitored for the possibility of endophthalmitis. Disclosures All authors: No reported disclosures.

2021 ◽  
Author(s):  
Yan-Jun ZHENG ◽  
Ting XIE ◽  
Lin WU ◽  
Xiao-Ying LIU ◽  
Ling ZHU ◽  
...  

Abstract BackgroundThe incidence of Candida bloodstream infections (BSIs), has increased over time. In this study, we aimed to describe the current epidemiology of Candida BSI in a large tertiary care hospital in Shanghai and to determine the risk factors of 28-day mortality and the impact of antifungal therapy on clinical outcomes. MethodsAll consecutive adult inpatients with Candida BSI at Ruijin Hospital from 2008.1 to 2018.12 were enrolled. Underlying diseases, clinical severity, species distribution, antifungal therapy, and their impact on the outcomes were analyzed. ResultsAmong the 370 inpatients with 393 consecutive episodes of Candida BSI, the incidence of nosocomial Candida BSI was 0.39 episodes/1000 hospitalized patients. Of the 393 cases, 299 (76.1%) were treated with antifungal therapy (247 and 52 were treated with early appropriate and targeted antifungal therapy, respectively). The overall 28-day mortality rate was 28.5%, which was significantly lower in those who received early appropriate (25.5%) or targeted (23.1%) antifungal therapy than in those who did not (39.4%; P=0.012 and P=0.046, respectively). In multivariate Cox regression analysis, age, chronic renal failure, mechanical ventilation, and neutropenia were found to be independent risk factors of 28-day mortality rate. Patients who received antifungal therapy had a lower mortality risk than did those who did not.ConclusionsThe incidence of Candida BSI has increased steadily in the past 11 years at our tertiary care hospital in Shanghai. Antifungal therapy influenced short-term survival, but no significant difference in mortality was observed between those who received early appropriate and targeted antifungal therapy.


Author(s):  
Sanjoy Kumar Kunti ◽  
Santanu Ghosh ◽  
Amrita Samanta ◽  
Indranil Chakraborty

Background: Metabolic syndrome (MS) is a pre-condition for cardiovascular diseases and type 2 diabetes mellitus (T2DM) which are major contributors to morbidity and mortality worldwide.Methods: The cross-sectional, observational study was conducted to estimate the proportion of MS and to explore crucial risk factors for MS among adult patients attending medicine OPD in a tertiary care hospital in West Bengal. The estimated final sample size was 315. Baseline socio demographic information and information on risk factors for MS, such as dietary habit, physical activity status, substance use, intake of related drugs, and presence of co-morbidities were collected by interviewing the patients with the help of a predesigned, pretested, structured schedule. Anthropometric measurements such as weight, height, waist circumference recordings were taken, and blood pressure was measured.Results: About 64% of the final study population (210/330) suffered from MS. On bivariate analysis, significant association between female gender (df=1, Pearson chi-square=5.06, p=0.024), weekly frequency of consumption of junk foods (df=3, Pearson chi-square=10.40, p=0.015) and obesity according to BMI (independent samples Mann-Whitney U test, p=0.010) at 5% level of significance were observed. Performing binary logistic regression analysis, obesity according to BMI (AOR=1.388, 95% CI=1.064-1.810) was found to be significant.Conclusions: Majority of the population suffered from MS who were mostly female, obese and consumers of junk foods. Appropriate interventional measures in terms of life style modification both at community and at tertiary care level are the need of the hour.


2015 ◽  
Vol 53 (7) ◽  
pp. 684-690 ◽  
Author(s):  
Xiurong Ding ◽  
Donghui Yan ◽  
Wei Sun ◽  
Zhaoyin Zeng ◽  
Ruirui Su ◽  
...  

Author(s):  
Sarwat Memon

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p<0.05). The right and left sided palatal rugae pattern showed significant difference in all three skeletal malocclusion groups (p<0.05). Conclusion: The present study showed no specific palatal rugae pattern associated with sagittal skeletal malocclusion. Further studies on larger sample and use of modern 3D technologies to scan the maxillary casts are required for results that are more precise.


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