칸디다뇨증 환자에 있어서 칸디다혈증 동반과 관련된 위험인자 분석
The risk factors in patients with candiduria associated with candidemia
소속 상세정보
김창오/Chang Oh Kim
김명환/심대근/조정호/김병극/김창년/송영구/김준명/Myoung Hwan Kim/Dae Keun Shim/Jung Ho Cho/Byoung Keuk Kim/Chang Nyun Kim/Young Goo Song/June Myung Kim
KMID : 0882420010600050479
Abstract
목적 : 조기진단 및 치료, 예후면에서 중요한 칸디다혈증은 칸디다뇨증의 약 10%에서 동반하는 것으로 되어있지만, 위험인자에 대하여는 아직까지 잘 알려져 있지 않다. 저자들은 칸디다뇨증 환자에 있어서 칸디다혈증 동반과 관련된 위험인자에 관하여 고찰하였다.
방법 : 1998년 1월부터 12월까지 연세대학교 의과대학 세브란스병원에 입원하였던 칸디다뇨증 환자 164명 중 칸디다혈증을 동반하지 않은 147명 (Group I)과 동반한 17명 (Group II)을 대상으로 하였고, 이들 환자들의 입원 기록을 후향적으로 조사하여 위험 인자를
분석하였다.
결과 : 1) Group I, Group II간의 평균연령은 각각 57.5세 및 62.5세였으며, 남녀의 비율은 양군간에 차이가 없었다. 2) 중심정맥관 삽입, 저혈압, 다른 감염성 질환이 동반하였던 경우, 중환자실 치료, 그리고 발열이 Group I보다 Group II에서 통계학적으로
괄목하게
많았다(53% vs 100%, 14% vs 59%, 64% vs 100%, 41% vs 76%, 46% vs 82%). 3) 요로계 시술 경력, 요관 삽입, 혈소판 감소 및 당뇨가 Group I에 비해서 Group II가 통계학적으로 많았다 (11% vs 88%, 63% vs 94%, 17% vs 41%, 8% vs 24%). 4) Group I, Group II의
소변에서
동정된 칸디다의 세균수 (cfu/mL)는 의미있는 차이가 없었다 (70,544.2 cfu/mL vs 74,411.8 cfu/mL). 5) 사망률은 Group I보다 Group II가 높았다 (27% vs 59%).
결론 : 칸디다뇨증 환자에 있어서 칸디다혈증의 동반과 관련된 보다 의의 있는 위험인자로 중심정맥관을 삽입하였던 경우, 저혈압, 다른 감염성 질환이 동반하였던 경우, 중환자실에서 치료를 받았던 경우, 발열 등이 있었다.
Background : The early diagnosis of candidemia is critical for the management. The candidemia is known to be associated with 10% of candiduria. But the risk factors in patients with candiduria who are associated with candidemia are not known. We
analyzed the risk factors in patients with candiduria who are associated with candidemia.
Methods : We retrospectively reviewed 164 patients with candiduria in Yonsei Medical Center from January 1998 to December 1998. Candiduria patients were divided into two groups. Candiduria patients without candidemia (Group I, 147 patients) and
candiduria patients with candidemia (Group II, 17 patients).
Results : 1) The mean age of the patients were 57.5 years in group I and 62.5 years in group II. There were no significant differences in the sex ratio between the two groups. 2) Central venous catheter insertion (53%, 100% in group I, II),
hypotension
(14%, 59% in group I, II), other associated infections (64%, 100% in group I, II), intensive care (41, 76% in group I, II) and fever (46%, 82% in group I, II) were the very significant risk factors in patients with candiduria who were associated
with
candidemia. 3) Urinary tract procedure (11%, 88% in group I, II), urinary catheter insertion (63%, 94% in group I, II), thrombocytopenia (17%, 41% in group I, II) and DM (8%, 24% in group I, II) were the significant risk factors of candidemia. 4)
Candida colony count (cfu/mL) of urine culture was not a significant risk factor. 5) Mortality rate (27%, 59% in group I, II) was significantly high in patients with candidemia.
Conclusion : Central venous catheter insertion, hypotension, other associated infections, intensive care and fever were the very significant risk factors of candidemia in patients with candiduria.
키워드
Candidiasis; Risk factors;
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