Initial management of candidemia at an academic medical center: Evaluation of the IDSA guidelines

Patel, Mukesh; Kunz, Daniele; Trivedi, Vivek; Jones, Marga; Moser, Stephen A.; Baddley, John W.

doi:10.1016/j.diagmicrobio.2004.12.010

Cited by 50 publications

(40 citation statements)

References 24 publications

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“…Second, there were important differences in patients who received daptomycin or linezolid therapy, including neutropenia and number of ID consultations. Differences in ID consultation may be relevant, as published reports demonstrate decreased mortality in patients with candidemia and staphylococcal bacteremia in patients who received ID consultation [32, 33]. Lastly, our finding that transplant patients had a lower mortality is likely spurious and suggests confounding in this investigation.…”

Section: Discussionmentioning

confidence: 68%

Observational study of the epidemiology and outcomes of vancomycin-resistantEnterococcusbacteraemia treated with newer antimicrobial agents

et al. 2010

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SUMMARY Vancomycin-resistant Enterococcus bloodstream infections (VRE-BSI) are a growing problem with few clinical trials to guide therapy. We conducted a retrospective study of management and predictors of mortality for VRE-BSI at a tertiary care centre from January 2005 to August 2008. Univariate and multivariable analyses examined the relationship of patient characteristics and antibiotic therapy with 30-day all-cause mortality. Rates of VRE-BSI increased from 0.06 to 0.17 infections/thousand patient days (p=0.03). Among 235 patients, 30-day mortality was 34.9%. Patients were primarily treated with linezolid (44.2%) or daptomycin (36.5%). Factors associated with mortality were haemodialysis (OR 3.2, 95% CI 1.6-6.3, p=0.007), mechanical ventilation (OR 3.7, 95% CI 1.3-10.4, p=0.01), and malnutrition (OR 2.0, 95% CI 1.0-4.0, p=0.046). Use of linezolid, but not daptomycin (p=0.052) showed a trend toward an association with survival. In conclusion, VRE-BSI is a growing problem, associated with significant 30-day mortality. Multiple factors were associated with poor outcomes at our hospital.

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Section: Discussionmentioning

confidence: 68%

Observational study of the epidemiology and outcomes of vancomycin-resistantEnterococcusbacteraemia treated with newer antimicrobial agents

et al. 2010

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“…Since 2005-2006, the proportion of hospitalized patients at our tertiary cancer center for whom infectious diseases consultation services were sought increased from 7.0 to 13.8% in 2011-2012 (Victor Mulanovich, personal communication, 15 January 2013). Existing literature, composed mostly of noncancer patients, showed the importance of infectious diseases consultation in reducing mortality associated with bloodstream infection, from S. aureus bacteremia [19] to candidemia [24,25]. The role of infectious diseases consultation in managing the transition from inpatient to outpatient settings was pointed out, including discontinuation of antibiotics, change to an oral agent, or change in selection of antibiotic [27,29].…”

Section: Resultsmentioning

confidence: 99%

“…A study conducted in Alabama showed a 33% increase in mortality associated with variation from guidelines (57 vs. 24%, P ¼ 0.003) [24]. In addition, infectious diseases consultation resulted in a 21% reduction in 6-week mortality (18 vs. 39%, P < 0.01) [24]. A study conducted in Japan demonstrated a 34% increase in 30-day survival (78 vs. 44%, P ¼ 0.04), 31% increase in appropriate antifungal use (81 vs. 50%, P ¼ 0.046), and 33% increase in appropriate duration of therapy (95 vs. 62%, P < 0.01) [25].…”

Section: Candidemiamentioning

confidence: 93%

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The impact of infectious diseases consultation on oncology practice

Granwehr¹,

Kontoyiannis

2013

Current Opinion in Oncology

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“…1 However, for specimens from colonized sites, the criteria continues to be controversial and still needs to be well established. We would like to share our past experience with an intensive care unit (ICU) patient who likely developed pneumonia due to Candida tropicalis (C. tropicalis), but the findings were ignored because of the difficulty in distinguishing infection from normal colonization.…”

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confidence: 99%

The Hidden Threats ofCandida spp.to the Respiratory Tract

Vidigal

Svidzinski

2010

Lab Med

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Candida spp. are considered opportunistic pathogens, even though they belong to the normal human microbiota. A critical point for health professionals is to distinguish fungal colonization from fungal infection, especially in pulmonary samples. The objective of the this study was to present evidence demonstrating that Candida tropicalis (C. tropicalis) was the likely source of pneumonia in a male patient. The evidence was not considered relevant to the treatment regime of the infection because specimens were obtained from sites normally colonized by Candida spp.

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Initial management of candidemia at an academic medical center: Evaluation of the IDSA guidelines

Cited by 50 publications

References 24 publications

Observational study of the epidemiology and outcomes of vancomycin-resistantEnterococcusbacteraemia treated with newer antimicrobial agents

Observational study of the epidemiology and outcomes of vancomycin-resistantEnterococcusbacteraemia treated with newer antimicrobial agents

The impact of infectious diseases consultation on oncology practice

The Hidden Threats ofCandida spp.to the Respiratory Tract

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