Incidence and outcome of invasive candidiasis in intensive care units (icus) in europe: Results of the eucandicu project
- Autori: 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.; Garcia-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.
- Anno di pubblicazione: 2019
- Tipologia: Articolo in rivista (Articolo in rivista)
- OA Link: http://hdl.handle.net/10447/360514
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.