TY - JOUR
T1 - Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe
T2 - results of the EUCANDICU project
AU - Bassetti, Matteo
AU - Giacobbe, Daniele R
AU - Vena, Antonio
AU - Trucchi, Cecilia
AU - Ansaldi, Filippo
AU - Antonelli, Massimo
AU - Adamkova, Vaclava
AU - Alicino, Cristiano
AU - Almyroudi, Maria-Panagiota
AU - Atchade, Enora
AU - Azzini, Anna M
AU - Carannante, Novella
AU - Carnelutti, Alessia
AU - Corcione, Silvia
AU - Cortegiani, Andrea
AU - Dimopoulos, George
AU - Dubler, Simon
AU - García-Garmendia, José L
AU - Girardis, Massimo
AU - Cornely, Oliver A
AU - Ianniruberto, Stefano
AU - Kullberg, Bart Jan
AU - Lagrou, Katrien
AU - Le Bihan, Clement
AU - Luzzati, Roberto
AU - Malbrain, Manu L N G
AU - Merelli, Maria
AU - Marques, Ana J
AU - Martin-Loeches, Ignacio
AU - Mesini, Alessio
AU - Paiva, José-Artur
AU - Peghin, Maddalena
AU - Raineri, Santi Maurizio
AU - Rautemaa-Richardson, Riina
AU - Schouten, Jeroen
AU - Brugnaro, Pierluigi
AU - Spapen, Herbert
AU - Tasioudis, Polychronis
AU - Timsit, Jean-François
AU - Tisa, Valentino
AU - Tumbarello, Mario
AU - van den Berg, Charlotte H S B
AU - Veber, Benoit
AU - Venditti, Mario
AU - Voiriot, Guillaume
AU - Wauters, Joost
AU - Montravers, Philippe
PY - 2019/6/14
Y1 - 2019/6/14
N2 - 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.
AB - 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.
KW - Aged
KW - Candidiasis, Invasive/complications
KW - Cross Infection/epidemiology
KW - Europe/epidemiology
KW - Female
KW - Humans
KW - Incidence
KW - Intensive Care Units/organization & administration
KW - Male
KW - Middle Aged
KW - Outcome Assessment, Health Care/methods
KW - Retrospective Studies
KW - Risk Factors
U2 - 10.1186/s13054-019-2497-3
DO - 10.1186/s13054-019-2497-3
M3 - Article
C2 - 31200780
VL - 23
SP - 219
JO - Critical Care
JF - Critical Care
SN - 1466-609X
IS - 1
ER -