Title :

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

Author(s) :

Poissy, Julien [Auteur]
Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576
Damonti, Lauro [Auteur]
Centre Hospitalier Universitaire Vaudois [Lausanne] [CHUV]
Bignon, Anne [Auteur]
Centre Hospitalier Régional Universitaire [Lille] [CHRU Lille]
Khanna, Nina [Auteur]
University Hospital Basel [Basel]
Von Kietzell, Matthias [Auteur]
Brustzentrum Kantonsspital St. Gallen
Boggian, Katia [Auteur]
Brustzentrum Kantonsspital St. Gallen
Neofytos, Dionysios [Auteur]
Hôpital Universitaire de Genève = University Hospitals of Geneva [HUG]
Vuotto, Fanny [Auteur]
Centre Hospitalier Régional Universitaire [Lille] [CHRU Lille]
Coiteux, Valérie [Auteur]
Centre Hospitalier Régional Universitaire [Lille] [CHRU Lille]
Artru, Florent [Auteur]
Centre Hospitalier Régional Universitaire [Lille] [CHRU Lille]
Zimmerli, Stephan [Auteur]
Bern University Hospital [Berne] [Inselspital]
Pagani, Jean-Luc [Auteur]
Université de Lausanne = University of Lausanne [UNIL]
Calandra, Thierry [Auteur]
Université de Lausanne = University of Lausanne [UNIL]
Sendid, Boualem [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995
Poulain, Daniel [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
van Delden, Christian [Auteur]
Hôpitaux Universitaires de Genève [HUG]
Lamoth, Frédéric [Auteur]
Université de Lausanne = University of Lausanne [UNIL]
Marchetti, Oscar [Auteur]
Centre Hospitalier Universitaire Vaudois [Lausanne] [CHUV]
Bochud, Pierre-Yves [Auteur]
Centre Hospitalier Universitaire Vaudois [Lausanne] [CHUV]

Journal title :

Critical Care

Abbreviated title :

Crit Care

Volume number :

24

Publisher :

Springer Science and Business Media LLC

Publication date :

2020-03-18

ISSN :

1364-8535

English keyword(s) :

Candidemia
Risk factors
Central venous catheter
Total parenteral nutrition
Scores
Antibiotics

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background 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 ...
Show more >Background 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. Methods 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. Results 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. Discussion 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). Conclusion This study provides novel risk scores for candidemia accounting for the hospital setting and recent progress in patients’ management strategies and fungal epidemiology.Show less >

Audience :

Internationale

Popular science :

Non

European Project :

Fungi in the setting of inflammation, allergy and autoimmune diseases:Translating basic science into clinical practices

Administrative institution(s) :

Université de Lille
CNRS

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
• Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576

Research team(s) :

Glycobiology in fungal Pathogenesis and Clinical Applications

Submission date :

2021-07-05T08:56:49Z
2021-07-07T08:19:12Z