tailieunhanh - Báo cáo y học: " The value of a risk model for early-onset candidemia"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: The value of a risk model for early-onset candidemia. | Available online http content 13 6 1005 Commentary The value of a risk model for early-onset candidemia Christian Sandrock and Javeed Siddiqui Division of Pulmonary and Critical Care Division of Infectious Diseases University of California Davis School of Medicine 4150 V Street 3400 Sacramento CA 95817 USA Corresponding author Christian Sandrock cesandrock@ Published 16 November 2009 This article is online at http content 13 6 1005 2009 BioMed Central Ltd Critical Care 2009 13 1005 doi cc8127 See related research by Shorr et al. http content 13 5 R156 Abstract Bloodstream infections from Candida species are associated with an increased length of stay increased hospital costs and higher mortality when compared with bacterial bloodstream infections. Delayed or inappropriate therapy in candidemia leads to increased mortality thus early recognition becomes paramount. With biomarkers showing promise blood cultures still remain the gold standard but require 24 to 72 hours for growth. The reliance on epidemiologic risk factors for the initiation of empiric antifungal therapy therefore provides the best method for early appropriate therapy. Shorr and colleagues have devised a risk score to identify patients with early-onset candidemia as defined by positive blood cultures within 2 days of admission thus allowing for the initiation of early appropriate antifungal therapy. In a previous edition of Critical Care Shorr and colleagues developed a simple weight risk score for identifying patients with candidemia upon hospital admission 1 . Using recursive partitioning they determined the best discriminators of Candida bloodstream infections in patients upon hospitalization identified as a positive blood culture 1 day prior to or 2 days after admission by retrospectively reviewing the CareFusion Outcomes Research Database comprising 64 109 bloodstream infection cases admitted to 176 acute care hospitals from 2000 to 2005. .