The aim of this study was to determine
candidemia incidence among
patients in a medical intensive-care unit (MICU) and the associated mortality rate and to identify
risk factors associated with
candidemia . We retrospectively performed a 13
matched case-control study of MICU
patients with
candidemia . Controls were matched for
sex , age, and
Acute Physiology and Chronic Health Evaluation (
APACHE ) II score.
Candidemia incidence was 9.1 per 1,000 admissions. The most common pathogen was
Candida albicans . Crude
mortality was 96% among
candidemia patients and 52% among controls (P<0.001).
Mortality differed significantly between the groups according to Kaplan-Meier
survival analysis (P=0.024).
Multivariate analysis identified the following independent
risk factors for
candidemia central venous catheterization (
odds ratio [OR] = 3.2, 95%
confidence interval [CI]=1.2-9.0), previous
steroid therapy (OR=4.7, 95% CI=1.8-12.1),
blood transfusion during the same admission period (OR=6.3, 95% CI=2.4-16.7), and
hepatic failure upon MICU admission (OR=6.9, 95% CI=1.7-28.4). In conclusion, we identify an additional independent
risk factor for
candidemia , the presence of
hepatic failure on MICU admission. Therefore, increased
awareness of
risk factors , including
hepatic failure , is necessary for the management of
candidemia .