Experience of a fungal infection after cardiac surgery

Autores de IIS La Fe

• Lara María Vicente Martinez

  Autor

• Rosario Vicente Guillen

  Autor

• Eva Calabuig Muñoz

  Autor

• Francisco Javier Escribá Alepuz

  Autor

• María Azucena Pajares Moncho

  Autor

• María Pilar Argente Navarro

  Autor

Grupos

• Anestesia y Cuidados Críticos

• Infección Grave

• Medicina Perioperatoria, Anestesiología y Reanimación

Abstract

Introduction and objectives: Patients undergoing cardiac surgery can have post-operative complications, including infections. The aim of this article was to study the incidence, severity and risk factors of invasive candidiasis in these patients, based on the hypothesis that several factors (multiple transfusions and time on extracorporeal circulation) are related to invasive candidiasis. Material and methods: The study included a prospective analysis of 669 patients undergoing scheduled cardiac surgery from April 2016 to December 2017. Control cultures were collected on admittance to the Surgical Intensive Care Unit. Results: The incidence of invasive candidiasis was 2.69%, being confirmed in 1.79% of cases. The most frequently isolated Candida species was Candida auris. Mortality rate in the invasive candidiasis group was 11% in the immediate post-operative period and 22% at 30 days. After the univariate study, a statistically significant relationship was found between invasive candidiasis and multiple transfusions (OR 15.86; 95% CI: 5.15-69.4; p<.001). A statistically significant relationship was also found with other known risk factors in hospitalised patients. Conclusions: Multiple transfusions are associated with an increased risk of invasive candidiasis. Surveillance measures for fungal infection in patients with risk factors undergoing cardiac surgery should be implemented in hospitals with a high incidence of candidiasis. (C) 2019 Sociedad Espanola de Anestesiologia, Reanimacion y Terapeutica del Dolor. Published by Elsevier Espana, S.L.U. All rights reserved.

Keywords

• Cardiac surgery; Fungal infection; Candidiasis; Multiple transfusions; Extracorporeal circulation; Post-operative complications