High rate of candidemia in patients sustaining injuries in a bomb blast at a marketplace: A possible environmental source

Dana G. Wolf, Itzhack Polacheck, Colin Block, Charles L. Sprung, Michael Muggia-Sullam, Yehuda G. Wolf, Arieh Oppenheim-Eden, Avraham Rivkind, Mervyn Shapiro

Research output: Contribution to journalArticlepeer-review

Abstract

In this study, a cluster of candidemia among patients sustaining injuries in a bomb blast at a marketplace was investigated by means of a multivariate analysis, a case-control study, and quantitative air sampling. Candidemia occurred in 7 (30%) of 21 patients (58% of those admitted to the intensive care unit [ICU]) between 4 and 16 days (mean, 12 days) after the injury and was the single most frequent cause of bloodstream infections. Inhalation injury was the strongest predictor for candidemia by multivariate analysis. Candidemia among the case patients occurred at a significantly higher rate than among comparable trauma patients injured in different urban settings, including a pedestrian mall (2 of 29; P = .02), and among contemporary ICU control patients (1 of 40; P = .001). Air sampling revealed exclusive detection of Candida species and increased mold concentration in the market in comparison with the mall environment. These findings suggest a role for an exogenous, environmental source in the development of candidemia in some trauma patients.

Original languageEnglish
Pages (from-to)712-716
Number of pages5
JournalClinical Infectious Diseases
Volume31
Issue number3
DOIs
StatePublished - 2000
Externally publishedYes

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