Risk factors for candidemia: a prospective matched case-control study

Autor: Poissy, Julien, Damonti, Lauro, Bignon, Anne, Khanna, Nina, von Kietzell, Matthias, Boggian, Katia, Neofytos, Dionysios, Vuotto, Fanny, Coiteux, Valérie, Artru, Florent, Zimmerli, Stephan, Pagani, Jean-Luc, Calandra, Thierry, Sendid, Boualem, Poulain, Daniel, van Delden, Christian, Lamoth, Frédéric, Marchetti, Oscar, Bochud, Pierre-Yves, Funginos, The, Study Groups, Allfun French
Přispěvatelé: Lille Inflammation Research International Center - U 995 (LIRIC), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Lausanne University Hospital, Université de Lausanne = University of Lausanne (UNIL), Bern University Hospital [Berne] (Inselspital), University of Bern, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), University Hospital Basel [Basel], University of Basel (Unibas), Brustzentrum Kantonsspital St. Gallen, Hôpitaux Universitaires de Genève (HUG), Université de Lille, Ensemble Hospitalier de la Côte (EHC), This work was supported by the Swiss National Foundation [grant number 324730-144054 and 33IC30_179636 to P.-Y.B], the Santos- Suarez Foundation (P.-Y.B), the Leenaards Foundation (P.-Y.B, O.M., and C.V.D), the Foundation for the Advancement in Medical Microbiology and Infectious Diseases (FAMMID) (P.-Y.B and O.M.), the European Union’s Seventh Framework Program (FP7/2007-2013) [grant agreement number HEALTH-2010–260338 (ALLFUN) to P.-Y. B., T.C., O.M., B.S., and D.P.], a grant from the French Society of Intensive Care (SRLF, to J.P.) and a 'Fonds d’Aide à l’Emergence' from the Lille University Hospital (to J.P.)., the FUNGINOS : J. D. Aubert, Ch. Berger, P.-Y. Bochud, K. Boggian, T. Calandra, A. Christe, A. Conen, C. Corti-Fragoso, P. Dutkowski, Ph. Eggimann, C. Garzoni, D. Goldenberger, N. Khanna, F. Lamoth, O. Marchetti, E. Marques Maggio, K. Mühlethaler, D. Neofytos, D. Sanglard, P. W. Schreiber, U. Schanz, C. van Delden, M. Von Kietzell, R. Zbinden & S. Zimmerli, Allfun French Study Groups : F. Artru, A. Bignon, V. Coiteux, D. Deblauw, A. El Kalioubie, K. Faure, N. François, T. Galpérine, B. Guéry, E. Jaillette, E. Kipnis, D. Mathieu, C. Nilès, E. Parmentier-Decrucq, J. Poissy, D. Poulain, S. Préau, L. Rahmania, L. Robriquet, A. Rouzé, B. Sendid, E. Vega, B. Voisin & P. Weyrich, European Project: 260338,EC:FP7:HEALTH,FP7-HEALTH-2010-single-stage,ALLFUN(2010), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), University of Lausanne (UNIL), Université de Lausanne (UNIL)
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Critical Care, Vol. 24, No 109 (2020)
Critical Care
Critical Care, 2020, 24, pp.109. ⟨10.1186/s13054-020-2766-1⟩
Critical Care, BioMed Central, 2020, 24, pp.109. ⟨10.1186/s13054-020-2766-1⟩
Critical Care, Vol 24, Iss 1, Pp 1-11 (2020)
ISSN: 1364-8535
1466-609X
DOI: 10.1186/s13054-020-2766-1⟩
Popis: International audience; Background: 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.Methods: 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.Results: 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.Discussion: 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).Conclusion: This study provides novel risk scores for candidemia accounting for the hospital setting and recent progress in patients’ management strategies and fungal epidemiology
Databáze: OpenAIRE
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