Русский
Risk factors for the probable development of invasive candidiasis in the HIV-infected
Charushina I.P., Feldblum I.V., Charushin A.O., Vorobyeva N.N., Zhebeleva Yu.A.
Academician E.A. Vagner Perm State Medical University, Ministry of Health of Russia
Subjects and methods. A case-control study was conducted in a specialized department of the Perm Regional Clinical Hospital for Infectious Diseases in 2012–2014. A case group included 43 patients with the confirmed diagnosis of IC; a control group consisted of 59 patients without IC. The groups were matched for sex, age, residence, stage of HIV infection, counts of CD lymphocytes, and the absence of antiretroviral therapy.
Results. The HIV-infected patients with IC were significantly more frequently observed to have factors, such as oropharyngeal candidiasis and tuberculosis, intensive care unit stay, prior gastrointestinal surgery and mechanical ventilation, active psychoactive substance dependence, stay in prison places, and the lack of a permanent job. To predict the development of IC in the HIV-infected, it is advisable to use at least three of the nine identified signs, the totality of which is characterized by the highest sensitivity (88.3%) and specificity (98.3%).
Conclusion. The identified factors can be used for the prediction of a risk for IC in HIV-infected patients, for timely examination, early diagnosis, and adequate therapy.
Literature
1. Brown G., Denning D., Gow N.A.R., Levitz S.M., Netea M.G., White T.C. Hidden Killers: Human Fungal Infections. Science Translational Med. 2012; 165(4): 1–9. 2. Blot S., Dimopoulos G., Rello J., Vogelaers D. Is Candida really a threat in the ICU? Curr. Opin. Crit. Care 2008; 14(5): 600–4. 3. Didone L. A novel assay of biofilm antifungal activity reveals that amphotericin B and caspofungin lyse Candida albicans cells in biofilms. Yeast 2011; 28(8): 561–8. 4. Hahnel S., Rosentritt M., Burgers R., Handel G., Lang R. Candida albicans biofilm formation on soft denture liners and efficacy of cleaning protocols. Gerodontology 2012; 29(2): 383–91. 5. Silva S., Negri M., Henriques M., Oliveira R., Williams D.W., Azeredo J. Adherence and biofilm formation of non-Candida albicans Candida species. Trends in Microbiology 2011; 19(5): 241–7. 6. Bouza E., Munoz P. Epidemiology of candidemia in intensive care units. Int. J. Antimicrob. Agents 2008; 32(Suppl. 2): 87–91. 7. Cleveland A.A., Farley M.M., Harrison L.H., Stein B., Hollick R., Lockhart S.R. Changes in incidence and antifungal drug resistance in candidemia: Results from population-based laboratory surveillance in Atlanta and Baltimore, 2008–2011. Clin. Infect. Dis. 2012; 55(10):1352–61. 8. Leroy O., Gangneux J.P., Montravers P., Mira J.P., Gouin F., Sollet J.P., Carlet J., Reynes J., Rosenheim M., Regnier B., Lortholary O. Epidemiology, management, and risk factors for death of invasive Candida infections in critical care: a multicenter, prospective, observational study in France (2005–2006). Crit. Care Med. 2009; 37(5): 1612–18. 9. Leon C., Ruiz-Santana S., Saavedra P., Galvan B., Blanco A., Castro C., Balasini C., Utande-Vazquez A., Gonzalez de Molina F., Blasco-Navalproto M., Lopez M.J., Charles P.E., Martin E., Hernandez-Viera M.A. 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. 10. Barinova A.N., Plavinskу S.L., Zajceva E.E. [Mycoses in HIV-infected patients]. Problemy medicinskoj mikologii 2012; 14(2): 34–8. (In Russ.). 11. Red’ko D.D., Shljaga I.D., Osipov V.A., Zhavoronok S.V. [Oropharyngeal candidiasis in HIV infection]. Materialy nauchno-prakticheskoj konferencii po medicinskoj mikologii (XI Kashkinskie chtenija) [Materials of scientific-practical conference on medical Mycology (XI Kashkin readings)]. Saint Petersburg, 2008; 10(2): 73–5. (In Russ.). 12. Ribeiro A.L., Menezes T.O., Alves-Junior S., Menezes S.A., Marques-da-Silva S.H., Vallinoto A.C. Oral carriage of Candida species in HIV-infected patients during highly active antiretroviral therapy (HAART) in Belem, Brazil. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. 2015; 120(1): 29–33. 13. [Diagnostics and treatment of fungal infections in intensive care units and intensive care. National guidelines]. Moscow, 2010. (In Russ.). 14. Pokrovsky V.V., ed. [HIV infection and AIDS. National leadership]. Moscow: GEOTAR-Media, 2013. 608 p. 15. Dimopoulos G., Ntziora P., Rachiotis G., Armaganidis A., Falagas M.E. Candida albicans versus non-albicans intensive care unit-acquired bloodstream infections: differences in risk factors and outcome. Anesthesia and Analgesia 2008; 106: 523–9. 16. Lebedeva T.N. [Immune candidiasis (overview)]. Problemy medicinskoj mikologii 2004; 6(4): 8–16. (In Russ.). 17. Bone R. Let’s agree on terminology: definitions of sepsis. Crit. Care Med. 1991; 19: 973–6.
About the Autors
For correspondence: Irina P. Charushina, ir-charushina@yandex.ru
Similar Articles
