Hospital-Acquired Candidemia

Wey, Sérgio Barsanti; Mori, Motomi; Pfaller, Michael A.; Woolson, Robert F.; Wenzel, Richard P.

doi:10.1001/archinte.1988.00380120094019

Cited by 652 publications

(14 citation statements)

References 23 publications

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“…General findings obtained in this study, including an incidence rate of 34.3 episodes of candidemia per 1,000 ICU patients and a crude mortality rate of 52.6% are consistent with previously published data [5,20]. Attributable ICU mortality to Candida -related bloodstream infection varies largely and has been estimated to be non-significantly different from that of patients without candidemia or to be higher by 5% to 40% [7,21,22].…”

Section: Discussionsupporting

confidence: 91%

Assessment of candidemia-attributable mortality in critically ill patients using propensity score matching analysis

et al. 2012

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IntroductionCandidemia in critically ill patients is usually a severe and life-threatening condition with a high crude mortality. Very few studies have focused on the impact of candidemia on ICU patient outcome and attributable mortality still remains controversial. This study was carried out to determine the attributable mortality of ICU-acquired candidemia in critically ill patients using propensity score matching analysis.MethodsA prospective observational study was conducted of all consecutive non-neutropenic adult patients admitted for at least seven days to 36 ICUs in Spain, France, and Argentina between April 2006 and June 2007. The probability of developing candidemia was estimated using a multivariate logistic regression model. Each patient with ICU-acquired candidemia was matched with two control patients with the nearest available Mahalanobis metric matching within the calipers defined by the propensity score. Standardized differences tests (SDT) for each variable before and after matching were calculated. Attributable mortality was determined by a modified Poisson regression model adjusted by those variables that still presented certain misalignments defined as a SDT > 10%.ResultsThirty-eight candidemias were diagnosed in 1,107 patients (34.3 episodes/1,000 ICU patients). Patients with and without candidemia had an ICU crude mortality of 52.6% versus 20.6% (P < 0.001) and a crude hospital mortality of 55.3% versus 29.6% (P = 0.01), respectively. In the propensity matched analysis, the corresponding figures were 51.4% versus 37.1% (P = 0.222) and 54.3% versus 50% (P = 0.680). After controlling residual confusion by the Poisson regression model, the relative risk (RR) of ICU- and hospital-attributable mortality from candidemia was RR 1.298 (95% confidence interval (CI) 0.88 to 1.98) and RR 1.096 (95% CI 0.68 to 1.69), respectively.ConclusionsICU-acquired candidemia in critically ill patients is not associated with an increase in either ICU or hospital mortality.

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Section: Discussionsupporting

confidence: 91%

Assessment of candidemia-attributable mortality in critically ill patients using propensity score matching analysis

et al. 2012

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“…[15][16][17] In our study, we noted 16.9% mortality. Age group ≥ 40 years (32% vs. 5.9%) was signiÞ cantly associated with mortality compared to age group < 40 years.…”

supporting

confidence: 58%

<i>Candida </i>spp. other than <i>Candida albicans</i>: A major cause of fungaemia in a tertiary care centre

Shivaprakasha¹,

Radhakrishnan²,

Karim³

2007

Indian J Med Microbiol

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“…However, even more alarming is the high overall and attributable mortality rate. In a historical control study with tight matches of controls and cases, Wey and colleagues reported a mortality rate of 38% (46% within one week of diagnosis) and a significantly increased duration of hospitalisation (30 days) for survivors [7,8]; these data are in accordance with European studies [9,10].…”

Section: Introductionsupporting

confidence: 55%

Fungal Cell Wall Inhibitors: Emphasis on Clinical Aspects

Maertens¹,

Boogaerts

2000

CPD

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Invasive fungal infections, mainly caused by Candida and Aspergillus species, are an emerging cause of morbidity and mortality among all categories of immunocompromised patients. Currently available antifungal agents, both polyenes, flucytosine and (tri)azoles are hampered by serious infusion- or drug-related toxicity, by hazardous drug-drug interactions, or by pharmacokinetic problems and by the development of resistance, in vitro as well as in vivo. In recent years, several companies have become interested in antifungal drug development and have launched new compounds into preclinical and clinical trials. Some of these agents target the fungal cell wall in stead of the cell membrane. They exert their fungicidal action through inhibition of the synthesis of critical compounds of that fungal cell wall, not present in mammalian cells. Exciting and promising agents include inhibitors of beta-(1,3)-D-glucan synthase and inhibitors of chitin synthase. These drugs appear well tolerated in Phase I-II studies and will soon enter Phase III studies. This review wants to provide the clinical framework for assessing the utility of these agents compared to existing antifungals, thereby focusing on invasive fungal disease and emphasising the changing fungal epidemiology and susceptibility in immunocompromised hosts.

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Hospital-Acquired Candidemia

Cited by 652 publications

References 23 publications

Assessment of candidemia-attributable mortality in critically ill patients using propensity score matching analysis

Assessment of candidemia-attributable mortality in critically ill patients using propensity score matching analysis

<i>Candida </i>spp. other than <i>Candida albicans</i>: A major cause of fungaemia in a tertiary care centre

Fungal Cell Wall Inhibitors: Emphasis on Clinical Aspects

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