Incidence and outcome of invasive candidiasis in intensive care units (icus) in europe: Results of the eucandicu project

Matteo Bassetti, Daniele R. Giacobbe, Antonio Vena, Cecilia Trucchi, Filippo Ansaldi, Massimo Antonelli, Vaclava Adamkova, Cristiano Alicino, Monica Alicino, Maria-Panagiota Almyroudi, Enora Atchade, Anna M. Azzini, Novella Carannante, Alessia Carnelutti, Silvia Corcione, Andrea Cortegiani, George Dimopoulos, Simon Dubler, José L. García-Garmendia, Massimo GirardisOliver A. Cornely, Stefano Ianniruberto, Bart Jan Kullberg, Katrien Lagrou, Clement Le Bihan, Roberto Luzzati, Manu L. N. G. Malbrain, Maria Merelli, Ana J. Marques, Ignacio Martin-Loeches, Alessio Mesini, José-Artur Paiva, Maddalena Peghin, Santi Maurizio Raineri, Riina Rautemaa-Richardson, Jeroen Schouten, Pierluigi Brugnaro, Herbert Spapen, Polychronis Tasioudis, Jean-François Timsit, Valentino Tisa, Mario Tumbarello, Charlotte H. S. B. Van Den Berg, Benoit Veber, Mario Venditti, Guillaume Voiriot, Joost Wauters, Philippe Montravers

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Abstract

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.
Original languageEnglish
Pages (from-to)219-219
Number of pages1
JournalCritical Care
Volume23
DOIs
Publication statusPublished - 2019

Keywords

  • Abdominal candidiasis
  • Aged
  • Candida
  • Candidemia
  • Candidiasis
  • Candidiasis, Invasive
  • Cross Infection
  • Europe
  • Female
  • Humans
  • ICU
  • Incidence
  • Intensive Care Units
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Retrospective Studies
  • Risk Factors

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