Co-variation between blood stream infections with Candida species versus Pseudomonas aeruginosa, Staphylococcus aureus, and other isolates among 60 ICU patient cohorts.

BACKGROUND

Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcal species, Coagulase-negative Staphylococci, Acinetobacter species, and Candida species are common blood stream infection (BSI) isolates among intensive care unit (ICU) cohorts. That Candida species might interact with bacteria at mucosal surfaces to facilitate invasive infections prompts the question as to the degree of co-variance between Candida species versus bacteria among BSI isolates.

OBJECTIVES

To estimate the co-variance between Candida species versus each of these five bacteria as BSI isolates among ICU patient cohorts.

METHODS

The literature was searched opportunistically for studies reporting ICU patient cohorts listing Candida species among BSI isolates. The associations of the BSI incidence proportion per 100 patients were converted to logits and modelled using ellipse plots.

RESULTS

The median overall BSI incidence proportion was 7.8% (interquartile range; 4.8%-11.6%). Among 60 cohorts (50 publications), correlation with the incidence proportion of Candidemia was apparent for Acinetobacter species (correlation coefficient = 0.69), Staphylococcus aureus (0.47), and Pseudomonas aeruginosa (0.4) but less so for Coagulase-negative Staphylococci (0.37) and Enterococcal species (0.32).

CONCLUSIONS

There are various degrees of co-variance between the BSI incidence proportion amongst the five types of bacteria and Candida species among ICU cohorts.