Titre
Risk factors for candidemia: a prospective matched case-control study.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Poissy, J.
Auteure/Auteur
Damonti, L.
Auteure/Auteur
Bignon, A.
Auteure/Auteur
Khanna, N.
Auteure/Auteur
Von Kietzell, M.
Auteure/Auteur
Boggian, K.
Auteure/Auteur
Neofytos, D.
Auteure/Auteur
Vuotto, F.
Auteure/Auteur
Coiteux, V.
Auteure/Auteur
Artru, F.
Auteure/Auteur
Zimmerli, S.
Auteure/Auteur
Pagani, J.L.
Auteure/Auteur
Calandra, T.
Auteure/Auteur
Sendid, B.
Auteure/Auteur
Poulain, D.
Auteure/Auteur
van Delden, C.
Auteure/Auteur
Lamoth, F.
Auteure/Auteur
Marchetti, O.
Auteure/Auteur
Bochud, P.Y.
Auteure/Auteur
Contributrices/contributeurs
Aubert, J.D.
Berger, C.
Bochud, P.Y.
Boggian, K.
Calandra, T.
Christe, A.
Conen, A.
Corti-Fragoso, C.
Dutkowski, P.
Eggimann, P.
Garzoni, C.
Goldenberger, D.
Khanna, N.
Lamoth, F.
Marchetti, O.
Maggio, E.M.
Mühlethaler, K.
Neofytos, D.
Sanglard, D.
Schreiber, P.W.
Schanz, U.
van Delden, C.
Von Kietzell, M.
Zbinden, R.
Zimmerli, S.
Artru, F.
Bignon, A.
Coiteux, V.
Deblauw, D.
El Kalioubie, A.
Faure, K.
François, N.
Galpérine, T.
Guéry, B.
Jaillette, E.
Kipnis, E.
Mathieu, D.
Nilès, C.
Parmentier-Decrucq, E.
Poissy, J.
Poulain, D.
Préau, S.
Rahmania, L.
Robriquet, L.
Rouzé, A.
Sendid, B.
Vega, E.
Voisin, B.
Weyrich, P.
Groupes de travail
FUNGINOS
Allfun French Study Groups
ISSN
1466-609X
Statut éditorial
Publié
Date de publication
2020-03-18
Volume
24
Numéro
1
Première page
109
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Publication Status: epublish
Résumé
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.
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.
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.
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).
This study provides novel risk scores for candidemia accounting for the hospital setting and recent progress in patients' management strategies and fungal epidemiology.
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.
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.
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).
This study provides novel risk scores for candidemia accounting for the hospital setting and recent progress in patients' management strategies and fungal epidemiology.
Sujets
PID Serval
serval:BIB_A42B1C805146
PMID
Open Access
Oui
Date de création
2020-04-01T19:25:59.857Z
Date de création dans IRIS
2025-05-21T03:22:41Z
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Nom
32188500_BIB_A42B1C805146.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by/4.0
Taille
852.35 KB
Format
Adobe PDF
PID Serval
serval:BIB_A42B1C805146.P001
URN
urn:nbn:ch:serval-BIB_A42B1C8051468
Somme de contrôle
(MD5):07c7b102c430b1fc8967b7db2e10c910