ESICM/ESCMID task force on practical management of invasive candidiasis in critically ill patients

Martín‐Loeches, Ignacio; Antonelli, Massimo; Cuenca‐Estrella, Manuel; Dimοpoulos, George; Einav, Sharon; Waele, Jan J. De; Garnacho-Montero, José; Kanj, Souha S.; Machado, Flávia Ribeiro; Montravers, Philippe; Sakr, Yasser; Sanguinetti, Maurizio; Timsit, Jean‐François; Bassetti, Matteo

doi:10.1007/s00134-019-05599-w

Cited by 152 publications

(167 citation statements)

References 128 publications

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“…According to the current published guidelines, prompt antifungal therapy and CVC removal are encouraged [8,10]. There have been several positive results regarding the effect of early intervention on mortality in ICU patients with candidemia [4,5,11].…”

Section: Discussionmentioning

confidence: 99%

Impact of host- and early treatment-related factors on mortality in ICU patients with candidemia: a bicentric retrospective observational study

et al. 2020

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Background: Candidemia is one of the most life-threatening infections among critically ill patients in the intensive care unit. However, the number of studies on the impact of host-and early treatment-related factors on mortality in this cohort is limited. The aim of this study was to investigate the relationship between clinically relevant factors, including early treatment (appropriate antifungal therapy and/or central venous catheter removal) and mortality in intensive care unit patients with candidemia. Methods: We performed a retrospective observational study in two Japanese University hospitals between January 2007 and December 2016. Adult intensive care unit patients with candidemia who met the following inclusion criteria: (1) ≥ 18 years old; (2) admitted in intensive care unit at the time of onset; and (3) central venous catheter in situ at the time of onset were included. We performed univariate and multivariate logistic regression analysis to identify factors associated with 30-day crude mortality. Results: A total of 68 patients met the inclusion criteria, 47 (69%) of whom were males. The median age was 68.0 (interquartile range, 61.0-76.0) years. The most common causative Candida species was Candida albicans (40 [59%] patients). With respect to the source of infection, central venous catheter-related candidemia was the most frequent (30 [44%] patients). Thirty-day crude mortality was 54% (37 patients). In multivariate logistic regression analysis, Acute Physiology and Chronic Health Evaluation II score (1-point increments) was the only factor that was independently associated with higher 30-day crude mortality. Other variables, including appropriate antifungal therapy and/or central venous catheter removal ≤ 24 h and ≤ 48 h following onset, did not significantly influence mortality. Conclusions: Candidemia in intensive care unit patients is still associated with high 30-day crude mortality rates. The only predictor of death was Acute Physiology and Chronic Health Evaluation II score ≤ 24 h following candidemia onset. Early empiric antifungal therapy and/or early CVC removal conferred no significant clinical benefit on survival in this patient population.

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Section: Discussionmentioning

confidence: 99%

Impact of host- and early treatment-related factors on mortality in ICU patients with candidemia: a bicentric retrospective observational study

et al. 2020

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“…A possible diagnostic work-flow to be adopted in ICU patients with suspected candidemia, based on the recent suggestions of a combined task force involving the systemic inflammation and sepsis and infection sections of the European Society of Intensive Care Medicine (ESICM) and the critically ill patients study group of European Society of Clinical Microbiology and Infectious Diseases (ESCMID), 17 is shown in ►Fig. 1, while a brief summary of the characteristics of laboratory tests for the diagnosis of candidemia is provided in ►Table 1.…”

Section: Diagnosismentioning

confidence: 99%

“…In light of the above epidemiological and mortality data, recognizing and appropriately treating patients with candidemia is considered an essential component of an optimized approach to ICU septic patients. [17][18][19] In this narrative review, we discuss the current state of the art regarding the diagnosis and therapy of candidemia in the ICU.…”

mentioning

confidence: 99%

Diagnosis and Treatment of Candidemia in the Intensive Care Unit

Bassetti

Giacobbe

Vena

et al. 2019

Semin Respir Crit Care Med

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Candidemia is the fourth most frequent health care-associated bloodstream infection, and the most frequent severe fungal infection developing in critically ill patients in intensive care units (ICUs). Diagnosis of candidemia in ICU patients is a complex task made of both early and late assessments involving both conventional diagnostic methods and novel rapid tests. Management strategies to optimize treatment of candidemia can be challenging and include starting early adequate therapy, use of an adequate dose and duration of therapy, de-escalating treatment whenever possible, and early discontinuation of useless antifungals in those with no definitive diagnosis of fungal infection. Herein, we will discuss recent epidemiological data on candidemia in ICUs and current diagnostic techniques before concentrating on antifungal treatments.

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“…Despite important and effective efforts have been made for reducing its unfavourable impact on patients’ health, candidaemia remains associated with high mortality and increased costs worldwide . Overall, Candida spp.…”

Section: Introductionmentioning

confidence: 99%

“…Despite important and effective efforts have been made for reducing its unfavourable impact on patients' health, candidaemia remains associated with high mortality and increased costs worldwide. [1][2][3][4][5] Overall, Candida spp. are the fourth to seventh more frequent cause of healthcare-associated bloodstream infections, with increasing incidence over time.…”

Section: Introductionmentioning

confidence: 99%

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

Giacobbe

Maraolo

Simeon

et al. 2020

Mycoses

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Summary Background Candidaemia remains associated with high mortality and increased costs worldwide. Objective To assess the changes over time in the relative prevalence of non‐albicans candidaemia (NAC). Methods A systematic review, meta‐analysis and meta‐regression were performed. Observational studies investigating the epidemiology of consecutive, non‐selected, candidaemia episodes were included. Two separated analyses were conducted: (a) whole hospital analysis and (b) intensive care unit (ICU) analysis. Results Starting from an initial total of 7726 records, 220 studies fulfilled inclusion criteria. The pooled prevalence of NAC in whole hospital analysis was 49.5% (95% confidence intervals [CI] 48.0‐51.1, I2 93.1%), while the pooled prevalence in ICU analysis was 50.6% (95% CI 46.6‐54.6; I2 86.7%). In meta‐regression, a progressive increase in NAC prevalence was observed in whole hospital analysis, although it explained only a small portion of between‐study variance (estimated yearly prevalence change +0.3%, 95% CI from +0.1% to +0.5%, P = .003; adjusted R2 3.42%) and was observed only in some continents in subgroup analyses. No relevant changes over time were observed in NAC prevalence for ICU studies. Conclusions We registered an increasing trend in the relative prevalence of NAC, which, nonetheless, seems to be limited to some continents and to contribute only minimally to explain the observed differences in NAC prevalence across studies.

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ESICM/ESCMID task force on practical management of invasive candidiasis in critically ill patients

Cited by 152 publications

References 128 publications

Impact of host- and early treatment-related factors on mortality in ICU patients with candidemia: a bicentric retrospective observational study

Impact of host- and early treatment-related factors on mortality in ICU patients with candidemia: a bicentric retrospective observational study

Diagnosis and Treatment of Candidemia in the Intensive Care Unit

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

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