| Abstract |
Background: Mycemia, especially candidemia, is among the most frequent nosocomial infections of the blood-borne infection worldwide and represents the most frequently occurring manifestation of invasive candidiasis. Regardless of continued advances in treatments and the availability of new antifungal drugs, it remains associated with high mortality rates, indicating the need for greater efforts to combat it.
Objective: The study of invasive infections in the ICU is vital to improving patient care, preventing the onset and spread of infections, addressing antimicrobial resistance, and overall health care practices.
Methods: In the context of this study, data from 72 patients at the PAGNI ICU were recorded. The recording of various parameters was done both at the time of their admission to the ICU (baseline) and at the time of the appearance of a positive culture in the blood, a recording was also made of patients without hematogenous infection during hospitalization in the ICU as control patients. The match-control of patients will be done according to age (±5 years), gender and duration of hospitalization (15 days)
Results: For the statistical analysis and correlation of the results, the statistical program IBM SPSS Statistics 29.0 type EXCEL 365 for Windows was used and processed qualitatively and quantitatively with the corresponding statistical model. The mean age of the patients was 70.9±11.8 years. In the study population there were 43(59.7%) male and 29(40.3%) female patients. Severity of disease at admission for the entire population was APPACHE II 17.99±6.2, SAPS II 37.85±14 and SOFA score 9.44±2.9 and did not differ between comparison groups. Mortality in the ICU and in the hospital in general differed significantly between patients with mycosis and all other study patients. (Dies with Mycosis N=16, 66.8% vs Dying All-Controls N=14, 29.2%, p=0.005 and Dying Mycosis N=20, 83.3% vs Dying All-Controls N=25, 52.1%, p=0.011 , respectively).
Conclusion: From the analysis of the results of the study carried out in the PAGNI ICU, the well-known fundamental nature of mortality in the ICU as a multifactorial phenomenon and the correlation of infections with the patient's outcome emerges. Understanding the mortality rates associated with invasive infections in the ICU is critical to assessing the severity and impact of these infections. High mortality rates in patients with specific acquired aggravating factors for the course of their hospitalization may be the stimulus to prompt further research such as this one into possible interventions and improvements in patient care. From the analysis, important findings emerged regarding the correlation of patients with mycemia, patients with bacteremia and those without bloodborne infection with the expected survival in the ICU and in their subsequent hospitalization. Among the latter, the existence or non-invasive infection, the Apache II score, the duration of hospitalization in the ICU, the duration of mechanical ventilation and comorbidity were identified as the strongest statistically associated variables. In conclusion, this study showed that there are no significant differences in the recording of fungal infections in the PAGNI ICU compared to what is already known from the international literature. Fungal infections, mainly like bacteremias, are a very important factor in increasing morbidity/mortality and should be seriously considered to avoid their occurrence as much as possible and secondly to detect them as early as possible to treat them in a targeted and methodical way. better patient outcome.
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