Abstract:
OBJECTIVES:: To characterize the epidemiology and burden of early-onset, nonnosocomial candidemia. DESIGN:: Retrospective review of Cardinal Health Outcomes Research Database, which comprises all acute care admissions at participating hospitals. SETTING:: A total of 176 acute care hospitals. PATIENTS:: All patients admitted from 2000 through 2005 who had early-onset bloodstream infection, defined as presence of both a positive blood culture drawn within 1 day before or within 48 hrs after hospital admission and an appropriate diagnostic code for infection. INTERVENTION:: None. MEASUREMENTS AND MAIN RESULTS:: To evaluate the impact of different pathogens on clinical and economic outcomes, we performed mixed-effect logistic and linear regression analyses and controlled for potential confounding factors. Of 64,307 early-onset bloodstream infections, 738 (1.2%) were positive for Candida. The rate of early-onset candidemia nearly doubled between 2000 and 2003 (p < .001) and then stabilized. Crude in-hospital mortality was higher for candidemia than for bacterial bloodstream infection (28.3% vs. 15.0%; p < .0001). Compared with patients with bacterial bloodstream infections, patients with candidemia were more likely to have been admitted within 30 days and to have been transferred from another healthcare facility. Compared with Gram-negative bacterial bloodstream infection and after controlling for other risk factors, candidemia was associated with increased mortality risk (odds ratio, 2.38; 95% confidence interval, 1.94-2.91; p < .0001), longer attributable hospital stay (4.8 days; 95% confidence interval, 4.1-5.5; p < .0001), and higher attributable hospital costs ($12,617; 95% confidence Interval, $10,755-$14,479; p < .0001). CONCLUSIONS:: Early-onset candidemia seems to be a distinct entity, which is increasing in frequency and is associated with increased mortality risk, longer hospital stay, and higher hospital costs relative to bacterial bloodstream infection.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Shorr AF,Gupta V,Sun X,Johannes RS,Spalding J,Tabak YPdoi
10.1097/CCM.0b013e3181a0f95dsubject
Has Abstractpub_date
2009-09-01 00:00:00pages
2519-26; quiz 2535issue
9eissn
0090-3493issn
1530-0293journal_volume
37pub_type
杂志文章abstract:UNLABELLED:Meningococcal septic shock (MSS) has high mortality and morbidity rates. In addition to the traditional prompt antibiotics and respiratory and circulatory support, new treatment strategies have been proposed. AGAINST THE INFLAMMATORY CASCADE:Immunotherapy, such as antiserum to Escherichia coli J5 and human ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200009001-00013
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVE:To assess hemodynamic, tissue oxygenation, and tissue perfusion changes by comparing traditional therapy (fluid resuscitation followed by vasopressor treatment) and alternative therapy (early vasopressor treatment) in a hyperkinetic and sedated model of endotoxic shock. DESIGN:Prospective controlled experime...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000269028.28521.08
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVE:Prognostic information is important to the family members of incapacitated, critically ill patients, yet little is known about what prognostic information physicians provide. Our objectives were to determine the types of prognostic information provided to families of critically ill patients when making major ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/01.CCM.0000254723.28270.14
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To determine whether mortality rates among intensive care unit (ICU) patients differ according to the time of ICU admission, we compared the death rates for patients admitted during weekday day shifts and off hours (from 6:30 pm to 8:29 am the next day for night shifts, from Saturday 1:00 pm to Monday 8:29 am...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000249832.36518.11
更新日期:2007-01-01 00:00:00
abstract::The intensive care unit (ICU) represents a hospital setting in which death and discussion about end-of-life care are common, yet these conversations are often difficult. Such difficulties arise, in part, because a family may be facing an unexpected poor prognosis associated with an acute illness or exacerbation and, i...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200102001-00006
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVE:To discuss a possible role of the endothelium in sepsis. DATA SOURCES:Studies published in biomedical journals and our own experimental results. STUDY SELECTION:Studies on endothelial mechanisms in the context of sepsis. DATA EXTRACTION AND SYNTHESIS:Changes in endothelial cells on activation by inflammato...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200107001-00011
更新日期:2001-07-01 00:00:00
abstract::As of October 1985, 37 candidates have passed the final examination in intensive care for the Diploma of Fellow of the Faculty of Anaesthetists, Royal Australasian College of Surgeons (FFARACS). In September 1984, 23 of these successful candidates responded to a questionnaire seeking information on their educational e...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198606000-00015
更新日期:1986-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the cardiopulmonary effects of the novel endothelin receptor antagonist tezosentan in endotoxin-induced lung injury in sheep and to assess the dose response to tezosentan and endothelin-1 in healthy sheep. DESIGN:Prospective, randomized, controlled experimental study. SETTING:University animal l...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000114575.08269.f6
更新日期:2004-03-01 00:00:00
abstract::The effect of positive end-expiratory pressure (PEEP) on PaO2 during collapse of a single pulmonary lobe was investigated in seven dogs. Increasing PEEP to the ventilated region of lung increased the proportion of cardiac output flowing to the collapsed lobe and decreased PaO2 and pH. PaCO2 increased at the onset of l...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198505000-00004
更新日期:1985-05-01 00:00:00
abstract::A simple, safe, and effective system for umbilical artery monitoring controls continuous fluid infusion to prevent fluid overinfusion and keep the catheter from clotting. Accurate and continuous pressure measurements can be recorded simultaneously with fluid infusion. A convenient method for checking dynamic response ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198207000-00009
更新日期:1982-07-01 00:00:00
abstract:OBJECTIVE:Keratinocyte growth factor (KGF) is expressed primarily by fibroblasts, is important for alveolar epithelial proliferation/function, and protects against lung injury in multiple animal models. We wished to determine whether acute lung injury/acute respiratory distress syndrome (ALI/ARDS) alveolar fluid induce...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31819fc81a
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:The benefit of continuous on-site presence by a staff academic critical care specialist in the intensive care unit of a teaching hospital is not known. We compared the quality of care and patient/family and provider satisfaction before and after changing the staffing model from on-demand to continuous 24-hr c...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/01.CCM.0000297887.84347.85
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND AND METHODS:We aimed to characterize the effects of an endotoxin insult (Escherichia coli 0127:B8) on the relationships between pulmonary vascular pressure and flow in intact dogs. To achieve this goal, multipoint plots of total pressure gradient, arterial pressure gradient, and venous pressure gradient vs. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199207000-00018
更新日期:1992-07-01 00:00:00
abstract::Estimations of blood glucose in the range 0-80 mg/dl were performed using the Chemstrip bG and StatTek Glucose Low Level test strips. Estimations of glucose levels closely approximated values obtained by a quantitative, enzymatic reference method; both appear to be excellent screening tests for hypoglycemia. There wer...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:1983-04-01 00:00:00
abstract::Hemodynamic, respiratory, and cerebral variables during 2 h of standard external CPR were studied in 5 dogs. In an additional 12 dogs, possible augmentation of these variables by Military Anti-Shock Trousers (MAST) was evaluated. In 9 dogs, external and internal cardiac massage were compared. During ventricular fibril...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198003000-00012
更新日期:1980-03-01 00:00:00
abstract:OBJECTIVE:Because anemia of inflammation is common in ICU patients and hepcidin is the key regulator of iron homeostasis, we examined time-dependent changes in hepcidin, erythropoietin, iron, and inflammatory markers in surgical ICU patients with anemia. DESIGN:Prospective single-center clinical noninterventional stud...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003089
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To analyze plasma interferon-gamma and interleukin-10 concentrations in patients with systemic meningococcal disease and patients with severe Gram-positive septic shock caused by Streptococcus pneumoniae or Staphylococcus aureus. To study the in vitro cytokine (interferon-gamma and interleukin-10) responses i...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000104950.52577.97
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:To assess the coping strategies used by family decision makers of adult critical care patients during and after the critical care experience and the relationship of coping strategies to posttraumatic stress symptoms experienced 60 days after hospitalization. DESIGN:A single-group descriptive longitudinal cor...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000934
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:To investigate the association of collaboration between intensive care unit (ICU) physicians and nurses and patient outcome. DESIGN:Prospective, descriptive, correlational study using self-report instruments. SETTINGS:A community teaching hospital medical ICU, a university teaching hospital surgical ICU, an...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/00003246-199909000-00045
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVES:There is controversy regarding the benefits of N-acetylcysteine in acute kidney injury. This study was to compare three commonly used regimens and explore which regimen is best for the protection of acute kidney injury. DESIGN:Prospective experimental study. SETTING:University research laboratory. INTERVE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31822575fc
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:Phenylephrine is often used for management of cerebral perfusion pressure after traumatic brain injury, but can have undesirable actions. Few studies have evaluated alternatives. The hypothesis was that arginine vasopressin was as effective as phenylephrine for maintaining tissue oxygenation during cerebral p...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181847af3
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the role of amino acid profiles in septic encephalopathy. DESIGN:Retrospective analysis. SETTING:Medical wards and medical ICU of a university hospital. PATIENTS:Patients with infections and normal mental status were compared with patients with septic shock and altered sensorium. INTERVENTIONS...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199106000-00004
更新日期:1991-06-01 00:00:00
abstract:OBJECTIVE:To compare the effects of continuous negative extrathoracic pressure (CNEP) and positive end-expiratory pressure (PEEP) at the same level of transpulmonary pressure. DESIGN:Prospective analysis. SETTING:Medical intensive care unit of a university hospital. PATIENTS:Nine consecutive acute lung injury patien...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199806000-00021
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:To compare the results of cardiac output measurements obtained by lithium dilution and thermodilution. DESIGN:Case series, observational study. SETTING:High-dependency postoperative unit and intensive care unit of a teaching hospital. PATIENTS:Forty patients were studied. Thirty-four patients had undergoin...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199711000-00015
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVES:Anxiety results from the anticipation of a threat and might be associated with poor outcome in the critically ill. This study aims at showing that anxiety at admission in critically ill patients is associated with new organ failure over the first 7 days of ICU hospitalization independently of baseline organ ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004495
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:To analyze the effects of an extracorporeal bioartificial liver containing alginate bead-entrapped hepatocytes on pigs with ischemia-induced acute hepatic failure. DESIGN:Prospective animal study. SETTING:University and INSERM laboratory. SUBJECTS:Fifteen Large White/Pietrin female pigs weighing 20-30 kg. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200203000-00027
更新日期:2002-03-01 00:00:00
abstract:OBJECTIVE:To assess the value of soluble triggering receptor expressed on myeloid cells-1 as a biomarker of infection in patients with neutropenic fever comparing with procalcitonin and C-reactive protein. DESIGN:Prospective, comparative, single-center study. SETTING:Hematology ward at a university hospital. SUBJECT...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31820a92dc
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:To compare the impact of two different customization strategies in the performance of the admission Mortality Probability Model II (MPM II0) using formal statistical assessment. DESIGN:Analysis of the database of a multicenter, multinational, prospective cohort study, EURICUS-1, involving 89 intensive care u...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199712000-00017
更新日期:1997-12-01 00:00:00
abstract::Measuring gas exchange in critically ill patients can provide valuable information on their nutritional status and energy expenditure. Several semiautomated machines are available for measuring oxygen consumption (VO2) and carbon dioxide production (VCO2). This study evaluated, under controlled laboratory conditions, ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198609000-00010
更新日期:1986-09-01 00:00:00
abstract:OBJECTIVE:The objective of the study is to test whether multimodal magnetic resonance imaging can provide a reliable outcome prediction of the clinical status, focusing on consciousness at 1 year after severe traumatic brain injury (TBI). DESIGN:Single center prospective cohort with consecutive inclusions. SETTING:Cr...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31819cf050
更新日期:2009-04-01 00:00:00