Clinical characteristics, management and outcome of patients with invasive candidiasis hospitalized in Internal Medicine Units: findings from a registry by the Italian Scientific Society FADOI
| Autor: | Pieralli, F., Dentali, F., Giusti, M., Ciarambino, T., Mazzone, A., Concia, E., Sanguinetti, M., Nallino, M. G., Morana, I., Santini, C., Gussoni, G., Zagarri, E., Manfellotto, D., Antonielli, E., Marchionni, L., Ariaudo, S., Benedetti, V., Sgroi, C., Pistella, E., Belfiore, A., Tedesco, A., Carrara, D., Magnani, E., Landini, F., Colagrande, P., Gerloni, R., Balbi, G., Gino, M., Limido, E., Norbiato, C. |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Societies Scientific medicine.medical_specialty Registry Antifungal Agents 030106 microbiology Candida Infection Internal Medicine Units Invasive candidiasis Candida parapsilosis Settore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Candidiasis Invasive 030212 general & internal medicine Registries Candida albicans Fluconazole Aged biology Candida glabrata business.industry Mortality rate Incidence (epidemiology) General Medicine biology.organism_classification medicine.disease Infectious Diseases Italy Concomitant Bacteremia business medicine.drug |
| Popis: | Invasive candidiasis (IC) is a challenging clinical condition, burdened by relevant mortality and morbidity. There is limited knowledge on the occurrence and management of IC in Internal Medicine Units (IMUs). Aim of this study was to provide real-world data on this topic. Consecutive objectively diagnosed cases of IC were collected in this prospective registry, which involved 18 IMUs in Italy. Patients were followed-up to 90 days from the diagnosis of candidemia. A total of 111 patients were observed (median age 78, IQR 67–83) for an overall incidence of infection of 1.89 cases/1000 hospital admissions. Candida albicans was the most frequent isolated species (62%), followed by Candida parapsilosis (17%) and Candida glabrata (13%). Echinocandins and fluconazole were used as initial therapy in 56.8 and 43.2% of patients, respectively. Antifungal therapy was started within 24 h in 18.9% of patients, in 40.6% in the period 1–3 days, and in 40.5% of patients more than 3 days after blood cultures. Death rate was 19.8% at 30 days and 40.5% at 90 days. At multivariable analysis concomitant bacteremia (i.e. polymicrobial sepsis), and fluconazole as the initial therapy were associated with an increased risk of death at 90 days. The incidence of IC is not negligible, and our registry confirmed that these patients have a relevant mortality rate at 90 days. Concomitant bacteremia, featuring polymicrobial sepsis, and starting antifungal treatment with fluconazole instead of echinocandins independently increase the risk of death. Efforts are needed to improve the awareness and management of IC in IMUs. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|