Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project
Matteo Bassetti,Matteo Bassetti,Daniele Roberto Giacobbe,Antonio Vena,Cecilia Trucchi,Filippo Ansaldi,Massimo Antonelli,Vaclava Adamkova,Cristiano Alicino,Maria-Panagiota Almyroudi,Enora Atchade,Anna Maria Azzini,Novella Carannante,Alessia Carnelutti,Silvia Corcione,Andrea Cortegiani,George Dimopoulos,Simon Dubler,Jose Luis Garcia-Garmendia,Massimo Girardis,Oliver A. Cornely,Stefano Ianniruberto,Bart Jan Kullberg,Katrien Lagrou,Clément Le Bihan,Roberto Luzzati,Manu L N G Malbrain,Maria Merelli,Ana J Marques,Ignacio Martin-Loeches,Alessio Mesini,José Artur Paiva,Maddalena Peghin,Santi Maurizio Raineri,Riina Rautemaa-Richardson,Jeroen Schouten,Pierluigi Brugnaro,Herbert D. Spapen,Polychronis Tasioudis,Jean-François Timsit,Valentino Tisa,Mario Tumbarello,Charlotte H S B van den Berg,Benoit Veber,Mario Venditti,Guillaume Voiriot,Joost Wauters,Philippe Montravers +47 more
TLDR
The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions, with important between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions.Abstract:
The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe. A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU). During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candidemia and IAC were 5.52 and 1.84 episodes per 1000 ICU admissions, respectively. Crude 30-day mortality was 42%. Age (odds ratio [OR] 1.04 per year, 95% CI 1.02–1.06, p < 0.001), severe hepatic failure (OR 3.25, 95% 1.31–8.08, p 0.011), SOFA score at the onset of IC (OR 1.11 per point, 95% CI 1.04–1.17, p 0.001), and septic shock (OR 2.12, 95% CI 1.24–3.63, p 0.006) were associated with increased 30-day mortality in a secondary, exploratory analysis. The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions. Future in-depth analyses will allow explaining part of the observed between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions.read more
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Bloodstream infections in critically ill patients with COVID-19.
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EORTC/MSGERC Definitions of Invasive Fungal Diseases: Summary of Activities of the Intensive Care Unit Working Group
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Epidemiology, clinical characteristics, and outcome of candidemia in critically ill patients in Germany: a single-center retrospective 10-year analysis.
Maria Schroeder,Theresa Weber,Timme Denker,Sarah Winterland,Dominic Wichmann,Holger Rohde,Ann-Kathrin Ozga,Marlene Fischer,Stefan Kluge +8 more
TL;DR: The mortality of critically ill patients with Candida BSI is high and is mainly determined by disease severity, multiorgan dysfunction, and antifungal management rather than species distribution and susceptibility, which underline the importance of timely treatment of candidemia.
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Changes in the relative prevalence of candidaemia due to non-albicans Candida species in adult in-patients: A systematic review, meta-analysis and meta-regression
Daniele Roberto Giacobbe,Alberto Enrico Maraolo,Vittorio Simeon,Federica Magnè,Maria Caterina Pace,Ivan Gentile,Paolo Chiodini,Claudio Viscoli,Maurizio Sanguinetti,Malgorzata Mikulska,Marco Fiore,Matteo Bassetti +11 more
TL;DR: Candidaemia remains associated with high mortality and increased costs worldwide and needs to be addressed to improve survival and reduce costs.
References
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International Study of the Prevalence and Outcomes of Infection in Intensive Care Units
Jean Louis Vincent,Jordi Rello,John C. Marshall,Eliezer Silva,Antonio Anzueto,Claude Martin,Rui Moreno,Jeffrey Lipman,Charles D. Gomersall,Yasser Sakr,Konrad Reinhart +10 more
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A multicenter study of septic shock due to candidemia: outcomes and predictors of mortality
Matteo Bassetti,Elda Righi,Filippo Ansaldi,Maria Merelli,Trucchi Cecilia,Gennaro De Pascale,Ana Díaz-Martín,Roberto Luzzati,Chiara Rosin,Leonel Lagunes,Enrico Maria Trecarichi,Maurizio Sanguinetti,Brunella Posteraro,José Garnacho-Montero,Assunta Sartor,Jordi Rello,Giorgio Della Rocca,Massimo Antonelli,Mario Tumbarello +18 more
TL;DR: Investigating the determinants of outcome in critically ill patients with septic shock due to candidemia found inadequate source control, inadequate antifungal therapy, and 1-point increments in the APACHE II score as independent variables associated with a higher 30-day mortality rate.
Journal ArticleDOI
Epidemiology of candidemia in intensive care units
Emilio Bouza,Patricia Muñoz +1 more
TL;DR: Several studies have shown that ICU patients with mucosal Candida colonization, particularly if multifocal, are at a higher risk for invasive candidiasis, and that colonization selects a population amenable to antifungal prophylaxis or empirical therapy.
Journal ArticleDOI
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Benoit Guery,Maiken Cavling Arendrup,Georg Auzinger,Elie Azoulay,Márcio Borges Sá,Elizabeth M. Johnson,Eckhard Müller,Christian Putensen,Coleman Rotstein,Gabriele Sganga,Mario Venditti,Rafael Zaragoza Crespo,Bart Jan Kullberg +12 more
TL;DR: To review the current management of invasive candidiasis and candidemia in non-neutropenic adult ICU patients based on a review of the literature and a European expert panel discussion, clinical scores were built from those risk factors.
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