Risk factors for candidemia: a prospective matched case-control study.

Details

Serval ID
serval:BIB_A42B1C805146
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Risk factors for candidemia: a prospective matched case-control study.
Journal
Critical care
Author(s)
Poissy J., Damonti L., Bignon A., Khanna N., Von Kietzell M., Boggian K., Neofytos D., Vuotto F., Coiteux V., Artru F., Zimmerli S., Pagani J.L., Calandra T., Sendid B., Poulain D., van Delden C., Lamoth F., Marchetti O., Bochud P.Y.
Working group(s)
FUNGINOS, Allfun French Study Groups
Contributor(s)
Aubert J.D., Berger C., Bochud P.Y., Boggian K., Calandra T., Christe A., Conen A., Corti-Fragoso C., Dutkowski P., Eggimann P., Garzoni C., Goldenberger D., Khanna N., Lamoth F., Marchetti O., Maggio E.M., Mühlethaler K., Neofytos D., Sanglard D., Schreiber P.W., Schanz U., van Delden C., Von Kietzell M., Zbinden R., Zimmerli S., Artru F., Bignon A., Coiteux V., Deblauw D., El Kalioubie A., Faure K., François N., Galpérine T., Guéry B., Jaillette E., Kipnis E., Mathieu D., Nilès C., Parmentier-Decrucq E., Poissy J., Poulain D., Préau S., Rahmania L., Robriquet L., Rouzé A., Sendid B., Vega E., Voisin B., Weyrich P.
ISSN
1466-609X (Electronic)
ISSN-L
1364-8535
Publication state
Published
Issued date
18/03/2020
Peer-reviewed
Oui
Volume
24
Number
1
Pages
109
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
Candidemia is an opportunistic infection associated with high morbidity and mortality in patients hospitalized both inside and outside intensive care units (ICUs). Identification of patients at risk is crucial to ensure prompt antifungal therapy. We sought to assess risk factors for candidemia and death, both outside and inside ICUs.
This prospective multicenter matched case-control study involved six teaching hospitals in Switzerland and France. Cases were defined by positive blood cultures for Candida sp. Controls were matched to cases using the following criteria: age, hospitalization ward, hospitalization duration, and, when applicable, type of surgery. One to three controls were enrolled by case. Risk factors were analyzed by univariate and multivariate conditional regression models, as a basis for a new scoring system to predict candidemia.
One hundred ninety-two candidemic patients and 411 matched controls were included. Forty-four percent of included patients were hospitalized in ICUs, and 56% were hospitalized outside ICUs. Independent risk factors for candidemia in the ICU population included total parenteral nutrition, acute kidney injury, heart disease, prior septic shock, and exposure to aminoglycoside antibiotics. Independent risk factors for candidemia in the non-ICU population included central venous catheter, total parenteral nutrition, and exposure to glycopeptides and nitroimidazoles. The accuracy of the scores based on these risk factors is better in the ICU than in the non-ICU population. Independent risk factors for death in candidemic patients included septic shock, acute kidney injury, and the number of antibiotics to which patients were exposed before candidemia.
While this study shows a role for known and novel risk factors for candidemia, it specifically highlights important differences in their distribution according to the hospital setting (ICU versus non-ICU).
This study provides novel risk scores for candidemia accounting for the hospital setting and recent progress in patients' management strategies and fungal epidemiology.
Keywords
Aged, Antifungal Agents/therapeutic use, Candidemia/mortality, Case-Control Studies, Central Venous Catheters, Cross Infection, Female, France, Hospitalization, Humans, Intensive Care Units/statistics & numerical data, Male, Middle Aged, Prospective Studies, Risk Factors, Switzerland, Antibiotics, Candidemia, Central venous catheter, Risk factors, Scores, Total parenteral nutrition
Pubmed
Open Access
Yes
Create date
01/04/2020 20:25
Last modification date
26/04/2020 5:26
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