Association between blood glucose levels and development of candidemia in hospitalized patients

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 ≥100 mg/dL (293 of 325 [90%] versus 849 of 1,007 [84%]; P = .009), ≥140 mg/dL (184 of 325 [57%] versus 507 of 1,007 [50%]; P = .049), and ≥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. (Endocr Pract. 2009;15:111-115).