Prevalence and clinical risk factors for esophageal candidiasis in non-human immunodeficiency virus patients:A multicenter retrospective case-control study  

作　　者：Alexandra V Kimchy AkramⅠAhmad Lindsey Tully Connor Lester Kavya Sanghavi Joseph J Jennings 

机构地区：[1]Department of Internal Medicine,MedStar Georgetown University Hospital,Washington,DC 20007,United States [2]Department of Internal Medicine,MedStar Washington Hospital Center,Washington,DC 20007,United States [3]Department of Internal Medicine,Georgetown University School of Medicine,Washington,DC 20007,United States [4]Department of Biostatistics and Biomedical Informatics,MedStar Research Institute,Hyattsville,MD 20781,United States [5]Department of Gastroenterology,MedStar Georgetown University Hospital,Washington,DC 20007,United States

出　　处：《World Journal of Gastrointestinal Endoscopy》2023年第6期480-490,共11页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：BACKGROUND Although esophageal candidiasis(EC)may manifest in immunocompetent individuals,there is a lack of consensus in the current literature about predisposing conditions that increase the risk of infection.AIM To determine the prevalence of EC in patients without human immunodeficiency virus(HIV)and identify risk factors for infection.METHODS We retrospectively reviewed inpatient and outpatient encounters from 5 regional hospitals within the United States(US)from 2015 to 2020.International Classification of Diseases,Ninth and Tenth Revisions were used to identify patients with endoscopic biopsies of the esophagus and EC.Patients with HIV were excluded.Adults with EC were compared to age,gender,and encounter-matched controls without EC.Patient demographics,symptoms,diagnoses,medications,and laboratory data were obtained from chart extraction.Differences in medians for continuous variables were compared using the Kruskal-Wallis test and categorical variables using chi-square analyses.Multivariable logistic regression was used to identify independent risk factors for EC,after adjusting for potential confounding factors.RESULTS Of the 1969 patients who had endoscopic biopsies of the esophagus performed from 2015 to 2020,295 patients had the diagnosis of EC.177 of 1969 patients(8.99%)had pathology confirming the diagnosis of EC and were included in the study for data collection and further analysis.In comparison to controls,patients with EC had significantly higher rates of gastroesophageal reflux disease(40.10%vs 27.50%;P=0.006),prior organ transplant(10.70%vs 2%;P<0.001),immunosuppressive medication(18.10%vs 8.10%;P=0.002),proton pump inhibitor(48%vs 30%;P<0.001),corticosteroid(35%vs 17%;P<0.001),Tylenol(25.40%vs 16.20%;P=0.019),and aspirin use(39%vs 27.50%;P=0.013).On multivariable logistic regression analysis,patients with a prior organ transplant had increased odds of EC(OR=5.81;P=0.009),as did patients taking a proton pump inhibitor(OR=1.66;P=0.03)or corticosteroids(OR=2.05;P=0.007).Patients with gastroesop

关 键 词：CANDIDIASIS ESOPHAGUS Endoscopy Proton pump inhibitors TRANSPLANTS GLUCOCORTICOIDS 

分 类 号：R519.3[医药卫生—内科学]