Klinički i laboratorijski biljezi rizika za nastanak invazivne kandidemije u pedijatrijskoj jedinici intenzivnog liječenja

doctoral thesis

• Title (english): Clinical and laboratory markers for the risk of invasive candidemia in the pediatric intensive care unit
• Author: Toni Matić
• Mentor: Sanja Pleško (mentor)
• Committee member: Jurica Vuković (predsjednik povjerenstva)
• Committee member: Ivana Mareković (član povjerenstva)
• Committee member: Bruno Baršić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2022-05-25, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Kandidemija je jedan od vodećih uzroka sepse u pedijatrijskoj jedinici intezivnog liječenja
(PJIL). Svrha ove studije bila je definirati karakteristike kandidemije i rizične faktore za
kandidemiju u PJIL-u te predložiti prediktivni model za identifikaciju pacijenata s rizikom.
Provedena je retrospektivna studija u kojoj su upareni slučajevi i kontrole u PJIL-u kroz
period od 9 godina. Četrdeset i dva slučajeva kandidemije upareno je s 84 kontrolna pacijenta.
Candida parapsilosis bila je najčešće izolirana vrsta (71.4%). Potvrđeni su neki od ranije
dokazanih rizičnih faktora, a otkriveni su i novi poput primjene dopamina ili inhibitora
protonske pumpe. Predložen je prediktivni model s tri rizična faktora - primjena >2
antibiotika u periodu do unazad maksimalno 4 tjedna prije kandidemije, prethodna bakterijska
infekcija dokazana u periodu do unazad maksimalno 4 tjedna prije kandidemije, trajanje
boravka na PJIL-u dulje od 10 dana. Prikazani model mogao bi pomoći u identifikaciji
pacijenata koji bi imali koristi od uvođenja profilaktičke antifungalne terapije.

Abstract (english)

Candidemia is one of the leading causes of bloodstream infections in the pediatric intensive
care unit (PICU). The aim of this study was to define characteristics and risk factors for
candidemia in the PICU setting and propose a predictive model to identify the patients at risk.
This was a retrospective matched case–control study in the PICU during a 9-year period.
Fourty two cases of candidemia were matched with 84 control patients. Candida parapsilosis
was the most common (71.4%) species. Previously reported risk factors for candidemia have
been confirmed and some new have been detected, specifically use of dopamine and use of
proton pump inhibitors. Predictive model for candidemia with three risk factors has been
formed - the use of >2 antibiotics in a maximum period of 4 weeks before the candidemia, a
previous bacterial infection in a maximum period of 4 weeks before the candidemia and the
duration of PICU stay of >10 days. The presented scoring system might help identify patients
who would benefit from prophylactic antifungal therapy.

• Keywords: Kandidemija; Antifungalna sredstva; Candida parapsilosis; dopamin; Inhibitori protonske pumpe; Jedinice intenzivne njege; pedijatrijske; Antibakterijska sredstva; Bakterijske infekcije
• Keywords (english): Candidemia; Antifungal Agents; Candida parapsilosis; Dopamine; Proton Pump Inhibitors; Intensive Care Units; Pediatric; Anti-Bacterial Agents; Bacterial Infections
• Language: croatian
• URN:NBN: urn:nbn:hr:105:157103
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 61 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-10-25 07:14:24