칸디다 균혈증에 대한 중재가 항진균제 사용 및 안과 검진에 미치는 영향

Abstract

Candidemia is increasing cause of mortality, especially in intensive care unit patients. And Candida endophthalmitis, developed with or without symptoms, has poor outcome. Prompt use of antifungal agents and early diagnosis of Candida endophthalmitis are clinically important to treat candidemia. In this study, we compared clinical, microbiological, ophthalmological characteristics and treatment outcomes whether infectious disease (ID) specialists mediate candidemia or not in a tertiary hospital by retrospective chart review. Group A includes patients who had candidemia at least one time from January 2012 to July 2013, without ID specialists mediation. Group B includes patients who had candidemia at least one time from August 2013 to December 2014, with ID specialists surveillances and mediations. We compared clinical manifestations of candidemia, uses of antifungal agent, ophthalmologic evaluations and treatment outcomes between two groups. In group A, rate of ophthalmologic evaluations was 4.4% and mean duration was 64.60 hours from blood culture to use of antifungal agents. In group B, the rate of ophthalmologic evaluations was 43.2% and mean duration was 50.15 hours. There was no statistically significant difference in clinical characteristics and 30-day mortality between two groups. Increasing rate of ophthalmologic evaluations and decreasing mean duration from blood culture to use of antifungal agents was shown in surveillance and mediation group.