The impact of age on risk assessment, therapeutic practice and outcome in candidemia

Hesstvedt, Liv; Gaustad, Peter; Müller, Fredrik; Andersen, Cecilie Torp; Brunborg, Cathrine; Mylvaganam, Haima; Leiva, Rafael Alexander; Berdal, Jan Erik; Ranheim, Trond Egil; Johnsen, Bjørn Odd; Falch, Birgit Margrethe; Grimnes, Gro; Skogen, Vegard; Haarr, Elisebet; Lyngøy, Anita Sandmo; Larssen, Kjersti Wik; Hannula, Raisa; Hansen, Bjørn Åsheim; Nordøy, Ingvild

doi:10.1080/23744235.2019.1595709

Cited by 20 publications

(27 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The change trend was similar to that reported by Oeser et al [38]. The overall morbidity and 30-day mortality in ICUs and hospitals in this study were similar to those in another hospital in this region of China [18], but lower than those in hospitals in other regions of China [35,37] and other countries [5,8,16,20,21,23,25,30]. The overall mortality rate of candidaemia has been reported to be 20-49% globally [39], and the mortality rate was 20.4% in our hospital, which is low compared to the global rate.…”

Section: Discussionsupporting

confidence: 90%

“…Our data showed that the median age of patients with candidaemia and the proportion of males were similar to those in other studies [8,[18][19][20][21][22][23]. Moreover, our study showed that the patients with candidaemia were hospitalised mostly in internal medicine wards, which is different from other studies that reporting hospitalisation mainly in ICU wards [8,22,[24][25][26][27], but similar to other studies [28][29][30][31].…”

Section: Discussionsupporting

confidence: 85%

See 1 more Smart Citation

A seven-year surveillance study of the epidemiology, antifungal susceptibility, risk factors and mortality of candidaemia among paediatric and adult inpatients in a tertiary teaching hospital in China

Zeng

Ding

Tian

et al. 2020

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

Background: There are no current national estimates of the candidaemia burden in China, and epidemiological candidaemia data from the underdeveloped region of China are lacking. Methods: A 7-year retrospective study was carried out to analyse the prevalence, species distribution, antifungal susceptibility, risk factors and inpatient mortality of candidaemia among paediatric and adult patients in a regional tertiary teaching hospital in China. Results: During the seven-year study period, a total of 201 inpatients with candidaemia were identified. The median age of the patients was 65 years (range, 1 day to 92 years), and 114 of the patients (56.7%) were male. The mean annual incidence of candidaemia was 0.26 cases per 1000 admissions (0.42 cases per 1000 paediatric admissions vs 0.24 cases per 1000 adult admissions, P < 0.05). Candida albicans was the most common fungal species (81/201, 40.3%) in all patients, Candida glabrata was the most common fungal species (18/35, 51.4%) in paediatric patients. Most isolates were susceptible to flucytosine (99.0%) and amphotericin B (99.0%), and the activity of antifungal agents against Candida species was no significant difference in satisfaction between paediatric and adult patients (P > 0.05). The all-cause mortality rate was 20.4% (paediatric patients: 11.4% vs adult patients: 22.3%, P > 0.05). Fewer univariate predictors of poor outcomes were identified for paediatric patients than for adult patients (4 vs 11 predictors). Respiratory dysfunction and septic shock were independent predictors of 30-day mortality for all patients. Conclusions: The epidemiological data of candidaemia in paediatric and adult patients are only different in the distributions of Candida species and the mean annual incidence of candidaemia. Flucytosine and amphotericin B can be used as first-choice agents when no antifungal susceptibility test results are available.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 85%

A seven-year surveillance study of the epidemiology, antifungal susceptibility, risk factors and mortality of candidaemia among paediatric and adult inpatients in a tertiary teaching hospital in China

Zeng

Ding

Tian

et al. 2020

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

show abstract

“…The use of echinocandins has increased as an initial therapy for candidaemia during the same period, and it might have decreased the mortality rate. The overall 30‐day mortality rate was similar to figures reported in other Nordic countries: Iceland (30%, 2013), Norway (36%, 2019) and Denmark (37%, 2011 and 43%, 2018) 5,29,31,36 . The 30‐day mortality was 20.0% in PC and 13.9% in non‐PC in our study, but the difference did not reach statistical significance.…”

Section: Discussionsupporting

confidence: 78%

“…This indicates an overall difference in species distribution between adult and child populations. C parapsilosis is a more common cause of candidaemia in children than in adults, 29,30 and this might not be a finding specific to PC C. albicans was the leading cause of both PC and non‐PC in our study; it is the leading cause of candidaemia overall in Northern Europe 29,31‐33 …”

Section: Discussionmentioning

confidence: 57%

Persistent vs non‐persistent candidaemia in adult patients in 2007‐2016: A retrospective cohort study

Ala-Houhala

2020

Mycoses

View full text Add to dashboard Cite

Mycoses. 2020;63:617-624. | 617 wileyonlinelibrary.com/journal/myc | INTRODUC TI ONCandida is a major cause of nosocomial infections, 1 and candidaemia causes significant mortality ranging between 30% and 45%. [2][3][4][5] Furthermore, candidaemia generates significant healthcare costs. 2 Its main complications include metastatic infection foci and death. 6 Persistent candidaemia (PC) is frequently recognised as another complication of candidaemia. Underlying factors that can influence the persistence of blood culture positivity in candidaemia Summary Objectives: Persistent candidaemia (PC) is a recognised complication of candidaemia. Our objective was to evaluate risk factors and clinical significance of PC in adult patients.Methods: This is a retrospective, cohort study. We compared PC with non-PC. All patients with blood cultures positive for Candida species were identified from a microbiological database in the hospital district of Helsinki and Uusimaa from 2007 to 2016. PC was defined as an isolation of the same Candida species from positive blood culture for ≥5 days. Results: PC criteria were fulfilled by 75/350 patients (21.4%). No significant difference emerged between persistent and non-persistent cases caused by non-albicans Candida species (37.3% vs 35.1%, P = .742). The length of hospital stay before onset of candidaemia was longer before PC (hospital stay > 7 days; 73.3% vs 59.6%, P = .043).No significant impact on 30-day mortality was observed (20.0% vs 15.5%, P = .422).Using multivariable regression analysis, we found the presence of central venous catheter (CVC) (OR = 2.71, 95% CI 1.31-5.59), metastatic infection foci (OR 3.60, 95% CI 1.66-7.79) and ineffective empirical treatment (OR = 3.31, 95% CI 1.43-7.65) to be independent risk factors for PC. In subgroup analysis, early source control was identified as a protective factor against PC (30.5% vs 57.7%, P = .002). Conclusion:The presence of CVC, metastatic infection foci and ineffective empirical treatment were independently associated with PC in adult patients. Active search for and treatment of metastatic infection foci and removal of CVC are key elements for preventing PC. K E Y W O R D S adult patients, central venous catheter, metastatic infection foci, Persistent candidaemia

show abstract

“…The change trend was similar to that reported by Oeser et al [38]. The overall morbidity and 30-day mortality in ICUs and hospitals in this study were similar to those in another hospital in this region of China [18], but lower than those in hospitals in other regions of China [35,37] and other countries [5,8,16,20,21,23,25,30]. The overall mortality rate of candidaemia has been reported to be 20%-49% globally [39], and the mortality rate was 20.4% in our hospital, which is low compared to the global rate.…”

Section: Discussionsupporting

confidence: 90%

A seven-year surveillance study of the epidemiology, antifungal susceptibility, risk factors and mortality of candidaemia among paediatric and adult inpaitents in a tertiary teaching hospital in China

Zeng

Ding

Tian

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: There are no current national estimates of the candidaemia burden in China, and epidemiological candidaemia data from the underdeveloped region of China are lacking. Methods: A 7-year retrospective study was carried out to analyse the prevalence, species distribution, antifungal susceptibility, risk factors and inpatient mortality of candidaemia among paediatric and adult patients in a regional tertiary teaching hospital in China. Results: During the seven-year study period, a total of 201 inpatients with candidaemia were identified. The median age of the patients was 65 years (range, 1 day to 92 years), and 114 of the patients (56.7%) were male. The mean annual incidence of candidaemia was 0.26 cases per 1,000 admissions (0.42 cases per 1,000 paediatric admissions vs 0.24 cases per 1,000 adult admissions, P<0.05). Candida albicans was the most common fungal species (81/201, 40.3%) in all patients, Candida glabrata was the most common fungal species (18/35, 51.4%) in paediatric patients. Most isolates were susceptible to flucytosine (99.0%) and amphotericin B (99.0%), and the activity of antifungal agents against Candida species was no significant difference in satisfaction between paediatric and adult patients(P>0.05). The all-cause mortality rate was 20.4% (paediatric patients: 11.4% vs adult patients:22.3%, P>0.05). Fewer univariate predictors of poor outcomes were identified for paediatric patients than for adult patients (4 vs 11 predictors). Respiratory dysfunction and septic shock were independent predictors of 30-day mortality for all patients. Conclusions: The epidemiological data of candidaemia in paediatric and adult patients are only different in the distributions of Candida species and the mean annual incidence of candidaemia. Flucytosine and amphotericin B can be used as first-choice agents when no antifungal susceptibility test results are available.

show abstract

The impact of age on risk assessment, therapeutic practice and outcome in candidemia

Cited by 20 publications

References 41 publications

A seven-year surveillance study of the epidemiology, antifungal susceptibility, risk factors and mortality of candidaemia among paediatric and adult inpatients in a tertiary teaching hospital in China

A seven-year surveillance study of the epidemiology, antifungal susceptibility, risk factors and mortality of candidaemia among paediatric and adult inpatients in a tertiary teaching hospital in China

Persistent vs non‐persistent candidaemia in adult patients in 2007‐2016: A retrospective cohort study

A seven-year surveillance study of the epidemiology, antifungal susceptibility, risk factors and mortality of candidaemia among paediatric and adult inpaitents in a tertiary teaching hospital in China

Contact Info

Product

Resources

About