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| Author(s): |
Maria Sileuda Moreira de Oliveira
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | Campinas, SP. |
| Institution: | Universidade Estadual de Campinas (UNICAMP). Instituto de Biologia |
| Defense date: | 2005-09-15 |
| Examining board members: |
Maria Luiza Moretti;
Arnaldo Lopes Colombo;
Maria Aparecida Shikanai Yasuda;
Marcelo Brocchi;
Helenice Bosco de Oliveira
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| Advisor: | Maria Luiza Moretti |
| Abstract | |
The diagnosis of candidemia is important for prompt initiation of antifungal therapy. Two hundred and twenty-five patients with high risk for candidemia who had blood cultures drawn and were hospitalized more than 15 days were prospectively followed-up in a two-year period. Whole-blood cultures by automated BactAlert® system and PCR were used to detect candidemia in all patients hospitalized for more than 15 days in high-risk areas. DNA was extracted and amplified using ITS5 and ITS4 base pair primers and the PCR products were sequenced for identification of Candida spp. Positive blood culture for Candida was considered the gold standard for candidemia diagnosis. Variables associated with the development of candidemia diagnosed by positive blood culture were also evaluated in the patients. The overall mortality of the patients was 26.1% and the mortality rate in candidemic and non-candidemic patients was 41.9% and 22.5%, respectively (p=0.009). PCR sensitivity and specificity were 72.1% and 91.2%, respectively. Positive and negative predictive values were 65.9% and 93.2%, respectively. The logistic regression of the multivariate analysis showed that parenteral nutrition (p<.0001); urinary underlying catheter (p=0.0177), chemotherapy (p=0.0246) and steroids (p=0.0283) were significant variables associated with the development of candidemia. The PCR technique followed by DNA sequencing was a helpful tool, in candidemia diagnosis (AU) | |