Dataset Information

Candidemia in critically ill immunocompromised patients: report of a retrospective multicenter cohort study.

ABSTRACT:

Background

Immunocompromised critically ill patients constitute a population with the high risk of candidemia. This retrospective study aimed to assess the outcome of immunocompromised critically ill patients with candidemia. Secondary objectives were to describe clinical phenotypes of these patients, Candida ecology, and factors associated with mortality.

Results

Overall, 121 patients were included in this study. Median delay from candidemia to first antifungal therapy was 3 days, in line with the observed delay of blood culture positivity. Candia albicans was the main Candida specie identified (54%), and susceptibility of Candida to fluconazole and echinocandins was of, respectively, 70% and 92%. Hospital mortality was of 60%. After adjustment for confounders, severity as assessed by the need for vasopressors (HR 1.8, CI95% 1.1-3.1), need for mechanical ventilation (HR 2.0, CI95% 1.1-3.8) and allogenic stem cell transplantation (HR 2.5, CI95% 1.1-6.0) were independently associated with poor outcome. Candida specie, susceptibility and treatment strategies were not associated with outcome.

Conclusions

Candidemia in immunocompromised critically ill patients is associated with a grim outcome. Despite the high prevalence of Candida non-albicans species, neither C. species nor its susceptibility was associated with outcome. Conversely, severity and preexisting allogeneic stem cell transplantation were independently associated with poor outcome. Despite antifungal prophylaxis and use of preemptive antifungal therapy in neutropenic patients, antifungal therapy was initiated three days after symptoms onset suggesting needs for specific strategies aiming to reduce this delay.

SUBMITTER: Ghrenassia E

PROVIDER: S-EPMC6546779 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Publications

Candidemia in critically ill immunocompromised patients: report of a retrospective multicenter cohort study.

Ghrenassia Etienne E Mokart Djamel D Mayaux Julien J Demoule Alexandre A Rezine Imène I Kerhuel Lionel L Calvet Laure L De Jong Audrey A Azoulay Elie E Darmon Michael M

Annals of intensive care 20190603 1

<h4>Background</h4>Immunocompromised critically ill patients constitute a population with the high risk of candidemia. This retrospective study aimed to assess the outcome of immunocompromised critically ill patients with candidemia. Secondary objectives were to describe clinical phenotypes of these patients, Candida ecology, and factors associated with mortality.<h4>Results</h4>Overall, 121 patients were included in this study. Median delay from candidemia to first antifungal therapy was 3 days ...[more]

PMID: 31161475

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Dataset Information

Candidemia in critically ill immunocompromised patients: report of a retrospective multicenter cohort study.

Background

Results

Conclusions

Publications

Candidemia in critically ill immunocompromised patients: report of a retrospective multicenter cohort study.

Similar Datasets

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