Περίληψη:
Background: The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe. Methods: A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU). Results: During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candidemia and IAC were 5.52 and 1.84 episodes per 1000 ICU admissions, respectively. Crude 30-day mortality was 42%. Age (odds ratio [OR] 1.04 per year, 95% CI 1.02-1.06, p < 0.001), severe hepatic failure (OR 3.25, 95% 1.31-8.08, p 0.011), SOFA score at the onset of IC (OR 1.11 per point, 95% CI 1.04-1.17, p 0.001), and septic shock (OR 2.12, 95% CI 1.24-3.63, p 0.006) were associated with increased 30-day mortality in a secondary, exploratory analysis. Conclusions: The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions. Future in-depth analyses will allow explaining part of the observed between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions. © 2019 The Author(s).
Συγγραφείς:
Bassetti, M.
Giacobbe, D.R.
Vena, A.
Trucchi, C.
Ansaldi, F.
Antonelli, M.
Adamkova, V.
Alicino, C.
Almyroudi, M.-P.
Atchade, E.
Azzini, A.M.
Carannante, N.
Carnelutti, A.
Corcione, S.
Cortegiani, A.
Dimopoulos, G.
Dubler, S.
García-Garmendia, J.L.
Girardis, M.
Cornely, O.A.
Ianniruberto, S.
Kullberg, B.J.
Lagrou, K.
Le Bihan, C.
Luzzati, R.
Malbrain, M.L.N.G.
Merelli, M.
Marques, A.J.
Martin-Loeches, I.
Mesini, A.
Paiva, J.-A.
Peghin, M.
Raineri, S.M.
Rautemaa-Richardson, R.
Schouten, J.
Brugnaro, P.
Spapen, H.
Tasioudis, P.
Timsit, J.-F.
Tisa, V.
Tumbarello, M.
Van Den Berg, C.H.S.B.
Veber, B.
Venditti, M.
Voiriot, G.
Wauters, J.
Montravers, P.
Λέξεις-κλειδιά:
abdominal infection; adult; aged; Article; disease severity; Europe; female; hospital admission; human; incidence; intensive care; intensive care unit; invasive candidiasis; liver failure; major clinical study; male; mortality rate; outcome assessment; priority journal; retrospective study; septic shock; Sequential Organ Failure Assessment Score; clinical trial; complication; cross infection; incidence; invasive candidiasis; middle aged; multicenter study; organization and management; procedures; risk factor, Aged; Candidiasis, Invasive; Cross Infection; Europe; Female; Humans; Incidence; Intensive Care Units; Male; Middle Aged; Outcome Assessment, Health Care; Retrospective Studies; Risk Factors
