The value of a risk model for early-onset candidemia 英文参考文献.docVIP

Available online /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 Critical Care 2009, 13:1005 (doi:10.1186/cc8127) This article is online at /content/13/6/1005 ? 2009 BioMed Central Ltd See related research by Shorr et al., /content/13/5/R156 Abstract hospitalization within 30 days; admission from another health- care facility; and mechanical ventilation. Recursive partition- ing revealed that the six best discriminators are age 64 years, 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 temperature 98°C, cachexia, previous hospitalization, admission from another healthcare facility, and mechanical ventilation. 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 the derivation cohort, those patients with one risk factor had a rate of candidemia of 0.4% while those with all six risk factors had a rate of 27.3%. In the validation cohort, the rates of cand