Titre
Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Kett, D.H.
Auteure/Auteur
Azoulay, E.
Auteure/Auteur
Echeverria, P.M.
Auteure/Auteur
Vincent, J.L.
Auteure/Auteur
Contributrices/contributeurs
Margarit, A.
Valentini, R.
Alan Javier, Z.
Bevilacqua, C.
Curone, M.
Rabuffetti, R.
Comignani, P.
Torres Boden, M.
Chertcoff, F.
Cardonatti, G.
Adén, F.
Marcos, L.
Dónofrio, M.
Fernández, R.
Lamberghini, R.
Balasini, S.
Teves, J.
Las Heras, M.
Sinner, J.
Ceraso, D.
Curcio, D.
Aguilar, L.
Weller, C.
Cardonnet, L.
Santa Cruz, R.
Manrique, E.
Bernardez, D.
Iolster, T.
Chiappero, G.
Curcio, D.
Ramos, P.
Vergara, J.
Moine, I.
Ilutovich, S.
Jannello, G.
Waschbusch, M.
Rios Picaza, G.
Raimondi, A.
Miriam, M.
Lovesio, C.
Curcio, D.
Caridi, M.
Leong, T.
Orford, N.
Reece, G.
Ernest, D.
Hawker, F.
Tan, J.
Giannellis, C.
Ihle, B.
Bersten, A.
McInnes, J.
Tallott, M.
Mcfadyen, B.
Vibert, J.
Parr, M.
Tran, K.
Sutton, J.
Webb, S.
Groves, N.
Cole, L.
Long, D.
Bass, F.
Erickson, S.
Lipman, J.
Long, D.
Delzoppo, C.
Thomas, J.
Dobb, G.
Daley, M.
Roberts, B.
Webb, S.
Santamaria, J.
Young, J.
Festa, M.
Holland, R.
Mullany, D.
Williams, P.
Corkeron, M.
Gales, M.
Banerjee, A.
Yung, M.
Mutz, N.
Hiesmayr, M.
Faybik, P.
Fitzgerald, R.
Firlinger, F.
Zasmeta, G.
Zink, M.
Sieber, W.
Hildegard, J.
Bakondy, R.
Schlieber, J.
Filzwieser, G.
Beer, R.
Joannidis, M.
Schuster, R.
Scherzer, W.
Smolle, K.
Fitzal, S.
Manzoor, R.
Brunain, J.
D'Hondt, A.
Huylenbroeck, G.
Van der Schueren, M.
't Kindt, H.
Slock, E.
Rijckaert, D.
Raemaekers, J.
Bourgeois, M.
Van Cotthem, I.
Nackaerts, G.
Gusu, D.
Gadisseux, P.
Vancollie, O.
Lignian, H.
Michel, P.
Fraipont, V.
Vander Stappen, M.
Forêt, F.
De Bels, D.
Devriendt, J.
Massaut, J.
Biston, P.
Roman, A.
Lambermont, B.
De Meulder, A.
Frederic, V.
Sottiaux, T.
Ruyffelaere, P.
Collin, V.
Anane, S.
Kleiren, P.
Simon, M.
Machayekhi, S.
Frans, E.
Leroy, G.
Berghmans, T.
Joseph, R.
Eerens, J.
Laterre, P.
Lagrou, B.
Rutsaert, R.
Pisarek, W.
Dive, A.
De Waele, J.
Spapen, H.
Damas, P.
Vincent, JL.
Malbrain, M.
Hidalgo, J.
Baptista, M.
Salgado, D.
Braga, M.
Avila, C.
Westphal, G.
Caser, E.
Alves, A.
Friedman, G.
Luz, M.
Assuncao, M.
Reis, H.
Gomes, A.
Silva, U.
Nogueira Fh, W.
El-Dash, S.
Valiatti, J.
Barbosa, A.
Coelho, C.
Knibel, M.
Minelli, C.
Caovilla, J.
Teixeira, G.
Hovnanian, A.
Rea-Neto, A.
Lobo, S.
Lugarinho, M.
Souza, P.
Ferreira, D.
Duarte, P.
Oliveira, M.
Marques, J.
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Rehder, P.
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Grilo, M.
Quesado, P.
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Silva, E.
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Wanderley, M.
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Duarte, P.
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Teles, J.
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Japiassú, A.
Villela, D.
Santos, C.
Passos, R.
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Silva, R.
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Gomez, J.
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Groupes de travail
Extended Prevalence of Infection in ICU Study (EPIC II) Group of Investigators
Liens vers les personnes
Liens vers les unités
ISSN
0090-3493
Statut éditorial
Publié
Date de publication
2011
Volume
39
Numéro
4
Première page
665
Dernière page/numéro d’article
670
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article Publication Status: ppublish
Résumé
OBJECTIVES: To provide a global, up-to-date picture of the prevalence, treatment, and outcomes of Candida bloodstream infections in intensive care unit patients and compare Candida with bacterial bloodstream infection.
DESIGN: A retrospective analysis of the Extended Prevalence of Infection in the ICU Study (EPIC II). Demographic, physiological, infection-related and therapeutic data were collected. Patients were grouped as having Candida, Gram-positive, Gram-negative, and combined Candida/bacterial bloodstream infection. Outcome data were assessed at intensive care unit and hospital discharge.
SETTING: EPIC II included 1265 intensive care units in 76 countries.
PATIENTS: Patients in participating intensive care units on study day.
INTERVENTIONS: None.
MEASUREMENT AND MAIN RESULTS: Of the 14,414 patients in EPIC II, 99 patients had Candida bloodstream infections for a prevalence of 6.9 per 1000 patients. Sixty-one patients had candidemia alone and 38 patients had combined bloodstream infections. Candida albicans (n = 70) was the predominant species. Primary therapy included monotherapy with fluconazole (n = 39), caspofungin (n = 16), and a polyene-based product (n = 12). Combination therapy was infrequently used (n = 10). Compared with patients with Gram-positive (n = 420) and Gram-negative (n = 264) bloodstream infections, patients with candidemia were more likely to have solid tumors (p < .05) and appeared to have been in an intensive care unit longer (14 days [range, 5-25 days], 8 days [range, 3-20 days], and 10 days [range, 2-23 days], respectively), but this difference was not statistically significant. Severity of illness and organ dysfunction scores were similar between groups. Patients with Candida bloodstream infections, compared with patients with Gram-positive and Gram-negative bloodstream infections, had the greatest crude intensive care unit mortality rates (42.6%, 25.3%, and 29.1%, respectively) and longer intensive care unit lengths of stay (median [interquartile range]) (33 days [18-44], 20 days [9-43], and 21 days [8-46], respectively); however, these differences were not statistically significant.
CONCLUSION: Candidemia remains a significant problem in intensive care units patients. In the EPIC II population, Candida albicans was the most common organism and fluconazole remained the predominant antifungal agent used. Candida bloodstream infections are associated with high intensive care unit and hospital mortality rates and resource use.
DESIGN: A retrospective analysis of the Extended Prevalence of Infection in the ICU Study (EPIC II). Demographic, physiological, infection-related and therapeutic data were collected. Patients were grouped as having Candida, Gram-positive, Gram-negative, and combined Candida/bacterial bloodstream infection. Outcome data were assessed at intensive care unit and hospital discharge.
SETTING: EPIC II included 1265 intensive care units in 76 countries.
PATIENTS: Patients in participating intensive care units on study day.
INTERVENTIONS: None.
MEASUREMENT AND MAIN RESULTS: Of the 14,414 patients in EPIC II, 99 patients had Candida bloodstream infections for a prevalence of 6.9 per 1000 patients. Sixty-one patients had candidemia alone and 38 patients had combined bloodstream infections. Candida albicans (n = 70) was the predominant species. Primary therapy included monotherapy with fluconazole (n = 39), caspofungin (n = 16), and a polyene-based product (n = 12). Combination therapy was infrequently used (n = 10). Compared with patients with Gram-positive (n = 420) and Gram-negative (n = 264) bloodstream infections, patients with candidemia were more likely to have solid tumors (p < .05) and appeared to have been in an intensive care unit longer (14 days [range, 5-25 days], 8 days [range, 3-20 days], and 10 days [range, 2-23 days], respectively), but this difference was not statistically significant. Severity of illness and organ dysfunction scores were similar between groups. Patients with Candida bloodstream infections, compared with patients with Gram-positive and Gram-negative bloodstream infections, had the greatest crude intensive care unit mortality rates (42.6%, 25.3%, and 29.1%, respectively) and longer intensive care unit lengths of stay (median [interquartile range]) (33 days [18-44], 20 days [9-43], and 21 days [8-46], respectively); however, these differences were not statistically significant.
CONCLUSION: Candidemia remains a significant problem in intensive care units patients. In the EPIC II population, Candida albicans was the most common organism and fluconazole remained the predominant antifungal agent used. Candida bloodstream infections are associated with high intensive care unit and hospital mortality rates and resource use.
Sujets
PID Serval
serval:BIB_7CE83D9AE1CE
PMID
Date de création
2012-02-06T15:36:11.022Z
Date de création dans IRIS
2025-05-21T01:06:34Z