scholarly journals Epidemiology and Outcomes of Candidaemia among Adult Patients Admitted at Hospital Universiti Sains Malaysia (HUSM): A 5-Year Review

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Haydar A
Keyword(s):  
Candida Albicans ◽  
Solid Tumor ◽  
Fungal Pathogens ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
Hospitalized Patients ◽  
Contributory Factor ◽  
Candida Spp ◽  
Patients With Diabetes ◽  
Surgical Conditions

Introduction: Candida organisms are opportunistic fungal pathogens that have become a major cause of nosocomial infections worldwide. We investigated the clinical characteristics and outcomes of hospitalized patients with candidaemia caused by Candida albicans and non-albicans Candida spp at HUSM. Materials and Methods: We retrospectively evaluated all hospitalized patients with candidaemia from January 2010 till December 2014 based on inpatient hospital records and laboratory data. Results: A total of 134 patients with candidaemia were enrolled. Candida albicans and non-albicans Candida spp were responsible for 20% (27/134) and 80% (107/134) of candidaemia cases, respectively. Hospitalized patients with diabetes mellitus, surgical conditions, or concomitant septicaemia and those who received instrumentations such as CVC or CBD, and those admitted under medical settings were prone to develop candidaemia caused by either C. albicans or non-albicans Candida spp. All isolates were susceptible to Fluconazole except for C. krusei isolates. All-cause mortality within 30 days post diagnosis of candidaemia was 59%. Factors associated with mortality were solid tumor (p =0.014), surgical illness (p=0.128), central venous catheterization (p= 0.096) and leucocytosis (p=0.116). Only solid tumor was an independent contributory factor for mortality among patients with C. albicans candidaemia in the multivariate analyses (OR 5.09, 95% CI 1.38,18.74, p=0.014). Conclusions: The patients’ clinical characteristics were fairly comparable between Candida albicans and non-albicans candidaemia. The changing epidemiology of candidaemia at this centre was in fact alarming. The outcome associated with candidaemia was poor.

scholarly journals Clinical characteristics and outcomes of symptomatic and asymptomatic hypoglycemia in hospitalized patients with diabetes

2018 ◽  
Vol 6 (1) ◽  
pp. e000607 ◽  
Author(s):  
Saumeth Cardona ◽  
Patricia C Gomez ◽  
Priyathama Vellanki ◽  
Isabel Anzola ◽  
Clementina Ramos ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Characteristics ◽  
Glycosylated Hemoglobin ◽  
General Medicine ◽  
Signs And Symptoms ◽  
Male Gender ◽  
Hospitalized Patients ◽  
Hospital Length Of Stay ◽  
Insulin Regimen ◽  
Patients With Diabetes

ImportanceThe frequency and impact of asymptomatic hypoglycemia in hospitalized patients with diabetes is not known.ObjectiveWe determined the clinical characteristics and hospital outcomes of general medicine and surgery patients with symptomatic and asymptomatic hypoglycemia.Research design and methodsProspective observational study in adult patients with diabetes and blood glucose (BG) <70 mg/dL. Participants were interviewed about signs and symptoms of hypoglycemia using a standardized questionnaire. Precipitating causes, demographics, insulin regimen, and complications data during admission was collected.ResultsAmong 250 patients with hypoglycemia, 112 (44.8%) patients were asymptomatic and 138 (55.2%) had symptomatic hypoglycemia. Patients with asymptomatic hypoglycemia were older (59±11 years vs 54.8±13 years, p=0.003), predominantly males (63% vs 48%, p=0.014), and had lower admission glycosylated hemoglobin (8.2%±2.6 % vs 9.1±2.9%, p=0.006) compared with symptomatic patients. Compared with symptomatic patients, those with asymptomatic hypoglycemia had higher mean BG during the episode (60.0±8 mg/dL vs 53.8±11 mg/dL, p<0.001). In multivariate analysis, male gender (OR 2.08, 95% CI 1.13 to 3.83, p=0.02) and age >65 years (OR 4.01, 95% CI 1.62 to 9.92, p=0.02) were independent predictors of asymptomatic hypoglycemia. There were no differences in clinical outcome, composite of hospital complications (27% vs 22%, p=0.41) or in-hospital length of stay (8 days (IQR 4–14) vs 7 days (IQR 5–15), p=0.92)) between groups.ConclusionsAsymptomatic hypoglycemia was common among insulin-treated patients with diabetes but was not associated with worse clinical outcome compared with patients with symptomatic hypoglycemia. Older age and male gender were independent risk factors for asymptomatic hypoglycemia.

scholarly journals Evaluation of the frequency of Candida spp. in hospitalized and non-hospitalized subjects

2018 ◽  
Vol 78 (4) ◽  
pp. 644-652 ◽  
Author(s):  
J. N. Vieira ◽  
A. M. Feijó ◽  
M. E. Bueno ◽  
C. L. Gonçalves ◽  
R. G. Lund ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Oral Cavity ◽  
Teaching Hospital ◽  
Candida Species ◽  
Hospitalized Patients ◽  
The Other ◽  
Medical Clinic ◽  
Candida Spp ◽  
Sabouraud Dextrose Agar ◽  
Peptone Water

Abstract The aim of this study was to evaluate the frequency of Candida species between a non-hospitalized and a hospitalized population. For this purpose, samples of saliva were sampled through sterile swabs, moistened in peptone water and rubbed in the oral cavity of 140 individuals, from which, 70 were hospitalized patients from the Medical Clinic of a Teaching Hospital and the other 70 were non-hospitalized subjects. All saliva samples were plated in Sabouraud Dextrose agar added with Chloramphenicol and incubated at 36 °C for 48 hours. The morphology identification was performed through macroscopic and microscopic characterization, the CHROMagar Candida medium and the VITEK® system Yeast Biochemical Card (bio Mérieux SA, France). The results showed a colonization of Candida spp. in 85.7% the hospitalized individuals, where the species found were C. albicans (60%), C. tropicalis (23.4%), C. krusei (3.3%) and Candida spp. (13.3%). In the non-hospitalized individuals the colonization by Candida spp was 47.1%, and the species found were: C. albicans (45.5%), C.krusei (9.1%), C. guilliermondii (9.1% %), C. tropicalis (3.0%), C. famata (3.0%) and Candida spp. (30.3%). In spite of their presence in oral cavity in both groups, Candida spp. was more frequently isolated in hospitalized individuals, who were 6.73 times more likely to have this fungus in the oral cavity and were 3.88 times more likely to have Candida albicans.

scholarly journals Identification of Candida spp. in the oral cavity in patients with malignant diseases

2017 ◽  
Vol 74 (11) ◽  
pp. 1066-1070 ◽  
Author(s):  
Irena Glazar ◽  
Jelena Prpic ◽  
Miranda Muhvic-Urek ◽  
Sonja Pezelj-Ribaric
Keyword(s):  
Candida Albicans ◽  
Oral Candidiasis ◽  
Clinical Manifestations ◽  
Fungal Growth ◽  
Hospitalized Patients ◽  
Control Group ◽  
Microbiological Analysis ◽  
Malignant Diseases ◽  
Candida Spp ◽  
Candida Kefyr

Background/Aim. Oral candidiasis frequently causes discomfort in patients treated for malignant diseases, acting as well as a potential source of systemic infection. This disease may present itself through different clinical manifestations of both acute or chronic type. The aim of this study was to identify different Candida species from oral cavities of patients suffering from malignant diseases. Methods. Thirty patients admitted to the hospital for diagnostics/treatment of malignant diseases were included in this investigation. All subjects had visible changes of oral mucosa in the form of pseudomembranes and inflammation corresponding to oral candidiasis. Control group included 30 non-hospitalized patients diagnosed with candidiasis. Diagnosis of oral candidiasis was confirmed in all patients by microbiological analysis of tongue swabs. For microbiota identification, three different tests were used: germination test, fungal growth test on corn meal agar, and biochemical identification with commercially available ID 32 C kit (bio-Merieux, Marcy-l?Etoile, France). Results. Out of 30 isolates collected from hospitalized patients, 90% was related to Candida albicans, 7% was identified as Candida kefyr, and 3% as Candida famata. In samples collected from non-hospitalized controls, we isolated Candida albicans in 90% of the cases, in 7% Candida kefyr, while in 3% we identified Candida glabrata. Conclusion. Based on this investigation, oral candidiasis in patients treated with radiotherapy and chemotherapy is mainly caused by Candida albicans. It is to be expected that Candida albicans will remain the most significant causative agent of oral candidasis, although we must bear in mind the possibility of other pathogenic species.

scholarly journals Clinical Characteristics and Outcomes of Patients With Diabetes Admitted for COVID-19 Treatment in Dubai: Single-Centre Cross-Sectional Study

10.2196/22471 ◽  
2020 ◽  
Vol 6 (4) ◽  
pp. e22471
Author(s):  
Rahila Bhatti ◽  
Amar Hassan Khamis ◽  
Samara Khatib ◽  
Seemin Shiraz ◽  
Glenn Matfin
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
Length Of Hospital Stay ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Patients With Diabetes ◽  
D Dimer

Background Recent studies have shown that diabetes is a major risk factor that contributes to the severity of COVID-19 and resulting mortality. Poor glycemic control is also associated with poor patient outcomes (eg, hospitalization and death). Objective This study aimed to describe the clinical characteristics and outcomes of patients with diabetes who were admitted to our hospital for COVID-19 treatment. Methods This cross-sectional, observational study comprised patients with diabetes admitted with COVID-19 to Mediclinic Parkview Hospital in Dubai, United Arab Emirates, from March 30 to June 7, 2020. We studied the differences among characteristics, length of hospital stay, diabetes status, comorbidities, treatments, and outcomes among these patients. Results Of the cohort patients, 25.1% (103/410) had coexistent diabetes or prediabetes. These patients represented 17 different ethnicities, with 59.2% (61/103) from Asian countries and 35% (36/103) from Arab countries. Mean patient age was 54 (SD 12.5) years, and 66.9% (69/103) of patients were male. Moreover, 85.4% (88/103) of patients were known to have diabetes prior to admission, and 14.6% (15/103) were newly diagnosed with either diabetes or prediabetes at admission. Most cohort patients had type 2 diabetes or prediabetes, and only 2.9% (3/103) of all patients had type 1 diabetes. Furthermore, 44.6% (46/103) of patients demonstrated evidence suggesting good glycemic control during the 4-12 weeks prior to admission, as defined arbitrarily by admission hemoglobin A1c level <7.5%, and 73.8% (76/103) of patients had other comorbidities, including hypertension, ischemic heart disease, and dyslipidemia. Laboratory data (mean and SD values) at admission for patients who needed ward-based care versus those who needed intensive care were as follows: fibrinogen, 462.8 (SD 125.1) mg/dL vs 660.0 (SD 187.6) mg/dL; D-dimer, 0.7 (SD 0.5) µg/mL vs 2.3 (SD 3.5) µg/mL; ferritin, 358.0 (SD 442.0) mg/dL vs 1762.4 (SD 2586.4) mg/dL; and C-reactive protein, 33.9 (SD 38.6) mg/L vs 137.0 (SD 111.7) mg/L. Laboratory data were all significantly higher for patients in the intensive care unit subcohort (P<.05). The average length of hospital stay was 14.55 days for all patients, with 28.2% (29/103) of patients requiring intensive care. In all, 4.9% (5/103) died during hospitalization—all of whom were in the intensive care unit. Conclusions Majority of patients with diabetes or prediabetes and COVID-19 had other notable comorbidities. Only 4 patients tested negative for COVID-19 RT-PCR but showed pathognomonic changes of COVID-19 radiologically. Laboratory analyses revealed distinct abnormal patterns of biomarkers that were associated with a poor prognosis: fibrinogen, D-dimer, ferritin, and C-reactive protein levels were all significantly higher at admission in patients who subsequently needed intensive care than in those who needed ward-based care. More studies with larger sample sizes are needed to compare data of COVID-19 patients admitted with and without diabetes within the UAE region.

scholarly journals Comparison of Clinical Characteristics and Outcomes between Outpatients and Hospitalized Patients with Diabetes and COVID-19

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Sergio Hernández-Jiménez
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Heart Rate ◽  
Respiratory Rate ◽  
Glucose Concentration ◽  
Clinical Characteristics ◽  
Hospitalized Patients ◽  
Critical Areas ◽  
Patients With Diabetes ◽  
Length Of Hospitalization

Background: Patients with diabetes and COVID-19 have higher rates of complications. Objective: To describe and identify the characteristics and outcomes in patients with diabetes and COVID-19. Methods: From March to June 2020, we included patients with diabetes and probable COVID-19 infection. We compared parameters between outpatients and hospitalized patients. A second analysis compared patients who died vs those who survived. Results: 243 patients, 37.6% women, with 56 ±12 years, and BMI 29.6 ±5.3 kg/m2 were included. Risk factors for hospitalization were oximetry <90% (HR 2.29, 95%CI 1.14-4.58) and mean blood pressure (MBP) <80 mmHg (HR 1.75, 95%CI 1.09-2.81). Age (HR 0.93, 95%CI 0.89-0.97), respiratory rate (RR) (HR 1.05, 95%CI 1.00-1.10) and PaFiO2 (HR 0.99, 95%CI: 0.98-1.00) predicted admission to critical areas. Risk factors for mortality were age ≥65 years (HR 2.88, 95%CI 1.61-5.17), RR ≥25 bpm (HR 3.86, 95%CI 1.33-11.12), heart rate (HR 1.82, 95%CI 0.96-3.42), PaFiO2 <100 (HR 3.70, 95%CI 1.06-6.65) and glucose ≥150 mg/dl (HR 2.57, 95%CI 1.05-6.25). Length of hospitalization was 8.5 (6-14) and 6 (2-10) days for discharged and deceased patients (p=0.003), respectively. Conclusion: Oximetry <90% and MBP <80 mmHg were associated with hospitalization requirement. Glucose concentration >150 mg/dl significantly predicted mortality.

scholarly journals Clinical Characteristics and Outcomes of Patients With Diabetes Admitted for COVID-19 Treatment in Dubai: Single-Centre Cross-Sectional Study (Preprint)

2020 ◽  
Author(s):  
Rahila Bhatti ◽  
Amar Hassan Khamis ◽  
Samara Khatib ◽  
Seemin Shiraz ◽  
Glenn Matfin
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
Length Of Hospital Stay ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Patients With Diabetes ◽  
D Dimer

BACKGROUND Recent studies have shown that diabetes is a major risk factor that contributes to the severity of COVID-19 and resulting mortality. Poor glycemic control is also associated with poor patient outcomes (eg, hospitalization and death). OBJECTIVE This study aimed to describe the clinical characteristics and outcomes of patients with diabetes who were admitted to our hospital for COVID-19 treatment. METHODS This cross-sectional, observational study comprised patients with diabetes admitted with COVID-19 to Mediclinic Parkview Hospital in Dubai, United Arab Emirates, from March 30 to June 7, 2020. We studied the differences among characteristics, length of hospital stay, diabetes status, comorbidities, treatments, and outcomes among these patients. RESULTS Of the cohort patients, 25.1% (103/410) had coexistent diabetes or prediabetes. These patients represented 17 different ethnicities, with 59.2% (61/103) from Asian countries and 35% (36/103) from Arab countries. Mean patient age was 54 (SD 12.5) years, and 66.9% (69/103) of patients were male. Moreover, 85.4% (88/103) of patients were known to have diabetes prior to admission, and 14.6% (15/103) were newly diagnosed with either diabetes or prediabetes at admission. Most cohort patients had type 2 diabetes or prediabetes, and only 2.9% (3/103) of all patients had type 1 diabetes. Furthermore, 44.6% (46/103) of patients demonstrated evidence suggesting good glycemic control during the 4-12 weeks prior to admission, as defined arbitrarily by admission hemoglobin A1<sub>c</sub> level &lt;7.5%, and 73.8% (76/103) of patients had other comorbidities, including hypertension, ischemic heart disease, and dyslipidemia. Laboratory data (mean and SD values) at admission for patients who needed ward-based care versus those who needed intensive care were as follows: fibrinogen, 462.8 (SD 125.1) mg/dL vs 660.0 (SD 187.6) mg/dL; D-dimer, 0.7 (SD 0.5) µg/mL vs 2.3 (SD 3.5) µg/mL; ferritin, 358.0 (SD 442.0) mg/dL vs 1762.4 (SD 2586.4) mg/dL; and C-reactive protein, 33.9 (SD 38.6) mg/L vs 137.0 (SD 111.7) mg/L. Laboratory data were all significantly higher for patients in the intensive care unit subcohort (<i>P</i>&lt;.05). The average length of hospital stay was 14.55 days for all patients, with 28.2% (29/103) of patients requiring intensive care. In all, 4.9% (5/103) died during hospitalization—all of whom were in the intensive care unit. CONCLUSIONS Majority of patients with diabetes or prediabetes and COVID-19 had other notable comorbidities. Only 4 patients tested negative for COVID-19 RT-PCR but showed pathognomonic changes of COVID-19 radiologically. Laboratory analyses revealed distinct abnormal patterns of biomarkers that were associated with a poor prognosis: fibrinogen, D-dimer, ferritin, and C-reactive protein levels were all significantly higher at admission in patients who subsequently needed intensive care than in those who needed ward-based care. More studies with larger sample sizes are needed to compare data of COVID-19 patients admitted with and without diabetes within the UAE region.

scholarly journals Healing below the ankle is possible in patients with diabetes mellitus and a forefoot gangrene

2021 ◽  
Vol 9 ◽  
pp. 205031212110291
Author(s):  
Targ Elgzyri ◽  
Jan Apelqvist ◽  
Eero Lindholm ◽  
Hedvig Örneholm ◽  
Magdalena Annersten Gershater
Keyword(s):  
Diabetic Foot ◽  
Clinical Characteristics ◽  
Foot Ulcer ◽  
Major Amputation ◽  
Severe Form ◽  
Foot Ulcers ◽  
Vascular Intervention ◽  
Co Morbidity ◽  
Patients With Diabetes

Background: Forefoot gangrene in patients with diabetes is a severe form of foot ulcers with risk of progress and major amputation. No large cohort studies have examined clinical characteristics and outcome of forefoot gangrene in patients with diabetes. The aim was to examine clinical characteristics and outcome of forefoot gangrene in patients with diabetes admitted to a diabetic foot centre. Methods: Patients with diabetes and foot ulcer consecutively presenting were included if they had forefoot gangrene (Wagner grade 4) at initial visit or developed forefoot gangrene during follow-up at diabetic foot centre. Patients were prospectively followed up until final outcome, either healing or death. The median follow-up period until healing was 41 (3–234) weeks. Results: Four hundred and seventy-six patients were included. The median age was 73 (35–95) years and 63% were males. Of the patients, 82% had cardiovascular disease and 16% had diabetic nephropathy. Vascular intervention was performed in 64%. Fifty-one patients (17% of surviving patients) healed after auto-amputation, 150 after minor amputation (48% of surviving patients), 103 had major amputation (33% of surviving patients) and 162 patients deceased unhealed. Ten patients were lost at follow-up. The median time to healing for all surviving patients was 41 (3–234) weeks; for auto-amputated, 48 (10–228) weeks; for minor amputated, 48 (6–234) weeks; and for major amputation, 32 (3–116) weeks. Conclusion: Healing without major amputation is possible in a large proportion of patients with diabetes and forefoot gangrene, despite these patients being elderly and with extensive co-morbidity.

Sign in / Sign up

Export Citation Format

Share Document