ICU-acquired candidaemia in France: Epidemiology and temporal trends, 2004-2013 - A study from the REA-RAISIN network
| Autor: | Alain Lepape, Sandrine Boussat, Olivier Baldesi, Stéphane Ruckly, Anne Berger-Carbonne, Caroline Bervas, Martine Aupee, Anaïs Machut, Anne Savey, F. L’Hériteau, Jean-François Timsit, Sébastien Bailly |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Male Pediatrics medicine.medical_specialty Antifungal Agents health care facilities manpower and services 030106 microbiology Candida tropicalis Cohort Studies 03 medical and health sciences Risk Factors Intensive care Severity of illness Epidemiology Prohibitins medicine Humans Prospective Studies Candida albicans Aged Candida Cross Infection biology Septic shock business.industry Mortality rate Incidence Candidemia Middle Aged biology.organism_classification medicine.disease Intensive Care Units Infectious Diseases Infectious disease (medical specialty) Catheter-Related Infections Emergency medicine Female France business |
| Zdroj: | The Journal of infection. 75(1) |
| ISSN: | 1532-2742 |
| Popis: | Summary Objective Candidaemia is a life-threatening infectious disease, associated with septic shock, multiple organ failure, and a high mortality rate. In France, reported data on the incidence of ICU-acquired candidaemia and the causative Candida species are scarce. The objective of this study was to determine temporal trends in epidemiology and risk factors of intensive care unit-acquired candidaemia (ICU-Cand) and ICU mortality among a very large population of ICU patients. Method Demographics, patient risk factors, invasive device exposure and nosocomial infection in ICU patient were collected from 2004 to 2013 in a national network of 213 ICUs: REA-RAISIN. Incidence and risk factors for candidaemia and ICU mortality were assessed. Results Out of 246,459 ICU patients, 851 developed an ICU-cand, representing 0.3 per 1000 patients-days. The incidence rose sharply over time. Candida albicans was the main species. The overall and ICU mortality was 52.4% in ICU-cand patients. The main risk factors of ICU-cand were length of stay, severity of illness and antimicrobial therapy at ICU admission, immune status and use of invasive procedure. ICU-cand was an independent risk factor of mortality (OR: 1.53; 95%CI [1.40–1.70]); in a sub-group analysis, independent effects on mortality were observed with C. albicans (OR: 1.45 [1.23–1.71]), Candida tropicalis (OR: 2.11 [1.31–3.39]) and "other" Candida species (OR: 1.64 [1.09–2.45]). Conclusion ICU candidaemia ranked sixth among bloodstream infections, and its average annual incidence was 0.3 per 1000 patients days. Despite of new therapy and international recommendation, the incidence rose sharply during the study period, and ICU mortality remained high. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect