Association between blood glucose levels and development of candidemia in hospitalized patients.
Endocr Pract. 2009 Mar-Apr;15(2):111-5
Authors: Shoham S, Han G, Granek T, Walsh T, Magee MF
OBJECTIVE: To examine the relationship between blood glucose levels in hospitalized patients and the risk of occurrence of candidemia. METHODS: We undertook a retrospective review of medical records and hospital computerized database information to compare blood glucose levels in 48 patients with nosocomial candidemia and 144 contemporaneous matched control subjects without candidemia at a tertiary teaching hospital. RESULTS: The proportions of days (for patients with candidemia versus control subjects without candidemia) with blood glucose levels >or=100 mg/dL (293 of 325 [90%] versus 849 of 1,007 [84%]; P = .009), >or=140 mg/dL (184 of 325 [57%] versus 507 of 1,007 [50%]; P = .049), and >or=200 mg/dL (80 of 325 [25%] versus 163 of 1,007 [16%]; P = .001) were significantly higher during the 7 days preceding the diagnosis of candidemia than during a 7-day period of hospitalization of control subjects. Blood glucose levels exceeding 200 mg/dL for 4 or more days of the week preceding the diagnosis of candidemia were significantly associated with its development (P = .04; odds ratio, 2.44; and 95% confidence interval, 1.01 to 5.94). CONCLUSION: Inpatient hyperglycemia is an important--and potentially modifiable-risk factor for development of nosocomial candidemia. These findings have implications for innovative infection control strategies that focus on glycemic control.
PMID: 19289320 [PubMed - indexed for MEDLINE]