Fungal Infections in the ICU during the COVID-19 Pandemic in Mexico
-
Published:2023-05-18
Issue:5
Volume:9
Page:583
-
ISSN:2309-608X
-
Container-title:Journal of Fungi
-
language:en
-
Short-container-title:JoF
Author:
Roman-Montes Carla M.12, Bojorges-Aguilar Saul12, Corral-Herrera Ever Arturo12, Rangel-Cordero Andrea2, Díaz-Lomelí Paulette2, Cervantes-Sanchez Axel2, Martinez-Guerra Bernardo A.12ORCID, Rajme-López Sandra12, Tamez-Torres Karla María12, Martínez-Gamboa Rosa Areli2, González-Lara Maria Fernanda12ORCID, Ponce-de-Leon Alfredo2ORCID, Sifuentes-Osornio José3
Affiliation:
1. Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Mexico City 14080, Mexico 2. Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Mexico City 14080, Mexico 3. General Direction, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Mexico City 14080, Mexico
Abstract
Background: Invasive Fungal Infections (IFI) are emergent complications of COVID-19. In this study, we aim to describe the prevalence, related factors, and outcomes of IFI in critical COVID-19 patients. Methods: We conducted a nested case–control study of all COVID-19 patients in the intensive care unit (ICU) who developed any IFI and matched age and sex controls for comparison (1:1) to evaluate IFI-related factors. Descriptive and comparative analyses were made, and the risk factors for IFI were compared versus controls. Results: We found an overall IFI prevalence of 9.3% in COVID-19 patients in the ICU, 5.6% in COVID-19-associated pulmonary aspergillosis (CAPA), and 2.5% in invasive candidiasis (IC). IFI patients had higher SOFA scores, increased frequency of vasopressor use, myocardial injury, and more empirical antibiotic use. CAPA was classified as possible in 68% and 32% as probable by ECMM/ISHAM consensus criteria, and 57.5% of mortality was found. Candidemia was more frequent for C. parapsilosis Fluconazole resistant outbreak early in the pandemic, with a mortality of 28%. Factors related to IFI in multivariable analysis were SOFA score > 2 (aOR 5.1, 95% CI 1.5–16.8, p = 0.007) and empiric antibiotics for COVID-19 (aOR 30, 95% CI 10.2–87.6, p = <0.01). Conclusions: We found a 9.3% prevalence of IFIs in critically ill patients with COVID-19 in a single center in Mexico; factors related to IFI were associated with higher SOFA scores and empiric antibiotic use for COVID-19. CAPA is the most frequent type of IFI. We did not find a mortality difference.
Subject
Plant Science,Ecology, Evolution, Behavior and Systematics,Microbiology (medical)
Reference53 articles.
1. Arastehfar, A., Shaban, T., Zarrinfar, H., Roudbary, M., Ghazanfari, M., Hedayati, M.T., Sedaghat, A., Ilkit, M., Najafzadeh, M.J., and Perlin, D.S. (2021). Candidemia among Iranian Patients with Severe COVID-19 Admitted to ICUs. J. Fungi, 7. 2. Epidemiology of Invasive Pulmonary Aspergillosis among Intubated Patients with COVID-19: A Prospective Study;Bartoletti;Clin. Infect. Dis.,2021 3. The Emergence of COVID-19 Associated Mucormycosis: A Review of Cases from 18 Countries;Hoenigl;Lancet Microbe,2022 4. Casalini, G., Giacomelli, A., Ridolfo, A., Gervasoni, C., and Antinori, S. (2021). Invasive Fungal Infections Complicating COVID-19: A Narrative Review. J. Fungi, 7. 5. Arastehfar, A., Carvalho, A., van de Veerdonk, F.L., Jenks, J.D., Koehler, P., Krause, R., Cornely, O.A., Perlin, D.S., Lass-Flörl, C., and Hoenigl, M. (2020). COVID-19 Associated Pulmonary Aspergillosis (CAPA)—From Immunology to Treatment. J. Fungi, 6.
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|