Characteristics and risk factors for 28-day mortality of hospital acquired fungemias in ICUs: data from the EUROBACT study

Abstract Background To characterize and identify prognostic factors for 28-day mortality among patients with hospital-acquired fungemia (HAF) in the Intensive Care Unit (ICU). Methods A sub-analysis of a prospective, multicenter non-representative cohort study conducted in 162 ICUs in 24 countries. Results Of the 1156 patients with hospital-acquired bloodstream infections (HA-BSI) included in the EUROBACT study, 96 patients had a HAF. Median time to its diagnosis was 20 days (IQR 10.5–30.5) and 9 days (IQR 3–15.5) after hospital and ICU admission, respectively. Median time to positivity of blood culture was longer in fungemia than in bacteremia (48.7 h vs. 38.1 h; p = 0.0004). Candida albicans was the most frequent fungus isolated (57.1 %), followed by Candida glabrata (15.3 %) and Candida parapsilosis (10.2 %). No clear source of HAF was detected in 33.3 % of the episodes and it was catheter-related in 21.9 % of them. Compared to patients with bacteremia, HAF patients had a higher rate of septic shock (39.6 % vs. 21.6 %; p = 0.0003) and renal dysfunction (25 % vs. 12.4 %; p = 0.0023) on admission and a higher rate of renal failure (26 % vs. 16.2 %; p = 0.0273) at diagnosis. Adequate treatment started within 24 h after blood culture collection was less frequent in HAF patients (22.9 % vs. 55.3 %; p