Impact of selective digestive decontamination on respiratory tract Candida among patients with suspected ventilator-associated pneumonia. A meta-analysis

The purpose here is to establish the incidence of respiratory tract colonization with Candida (RT Candida ) among ICU patients receiving mechanical ventilation within studies in the literature. Also of interest is its relationship with candidemia and the relative importance of topical antibiotic (TA...

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Bibliographic Details
Published in:European journal of clinical microbiology & infectious diseases 2016-07, Vol.35 (7), p.1121-1135
Main Author: Hurley, J. C.
Format: Article
Language:English
Subjects:
Antibiotics
Bacterial infections
Biomedical and Life Sciences
Biomedicine
Candida
Candidemia
Candidiasis - microbiology
Carrier State
Decontamination
Decontamination - methods
Female
Health services
Humans
Incidence
Infections
Intensive Care Units
Internal Medicine
Male
Medical Microbiology
Original Article
Patients
Pneumonia
Pneumonia, Ventilator-Associated - epidemiology
Pneumonia, Ventilator-Associated - etiology
Prevention
Respiration, Artificial - adverse effects
Respiratory System - microbiology
Respiratory tract
Risk factors
Ventilation
Ventilators
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Summary:The purpose here is to establish the incidence of respiratory tract colonization with Candida (RT Candida ) among ICU patients receiving mechanical ventilation within studies in the literature. Also of interest is its relationship with candidemia and the relative importance of topical antibiotic (TA) use as within studies of selective digestive decontamination (SDD) versus other candidate risk factors towards it. The incidence of RT Candida was extracted from component (control and intervention) groups decanted from studies of various TA and non-TA ICU infection prevention methods with summary estimates derived using random effects. A benchmark RT Candida incidence to provide overarching calibration was derived using (observational) groups from studies without any prevention method under study. A multi-level regression model of group level data was undertaken using generalized estimating equation (GEE) methods. RT Candida data were sourced from 113 studies. The benchmark RT Candida incidence is 1.3; 0.9–1.8 % (mean and 95 % confidence intervals). Membership of a concurrent control group of a study of SDD ( p  = 0.02), the group-wide presence of candidemia risk factors ( p  
ISSN:0934-9723
1435-4373
DOI:10.1007/s10096-016-2643-7