Risk factors for candidemia: a prospective ...
Type de document :
Article dans une revue scientifique
URL permanente :
Titre :
Risk factors for candidemia: a prospective matched case-control study
Auteur(s) :
Poissy, Julien [Auteur]
Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576
Damonti, Lauro [Auteur]
Bignon, Anne [Auteur]
Khanna, Nina [Auteur]
Von Kietzell, Matthias [Auteur]
Boggian, Katia [Auteur]
Neofytos, Dionysios [Auteur]
Vuotto, Fanny [Auteur]
Coiteux, Valérie [Auteur]
Artru, Florent [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Zimmerli, Stephan [Auteur]
Pagani, Jean-Luc [Auteur]
Calandra, Thierry [Auteur]
Sendid, Boualem [Auteur]
Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576
Poulain, Daniel [Auteur]
van Delden, Christian [Auteur]
Lamoth, Frédéric [Auteur]
Marchetti, Oscar [Auteur]
Bochud, Pierre-Yves [Auteur]
Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576
Damonti, Lauro [Auteur]
Bignon, Anne [Auteur]
Khanna, Nina [Auteur]
Von Kietzell, Matthias [Auteur]
Boggian, Katia [Auteur]
Neofytos, Dionysios [Auteur]
Vuotto, Fanny [Auteur]
Coiteux, Valérie [Auteur]
Artru, Florent [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Zimmerli, Stephan [Auteur]
Pagani, Jean-Luc [Auteur]
Calandra, Thierry [Auteur]
Sendid, Boualem [Auteur]
Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576
Poulain, Daniel [Auteur]
van Delden, Christian [Auteur]
Lamoth, Frédéric [Auteur]
Marchetti, Oscar [Auteur]
Bochud, Pierre-Yves [Auteur]
Titre de la revue :
Critical Care
Nom court de la revue :
Crit Care
Numéro :
24
Éditeur :
Springer Science and Business Media LLC
Date de publication :
2020-03-18
ISSN :
1364-8535
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
Abstract
Background
Candidemia is an opportunistic infection associated with high morbidity and mortality in patients hospitalized both inside and outside intensive care units (ICUs). ...
Lire la suite >Abstract 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.Lire moins >
Lire la suite >Abstract 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.Lire moins >
Audience :
Non spécifiée
Établissement(s) :
Université de Lille
CNRS
CNRS
Équipe(s) de recherche :
Glycobiology in fungal Pathogenesis and Clinical Applications
Date de dépôt :
2021-07-05T08:56:49Z