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; 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 Girardis; Oliver 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

doi:10.1186/s13054-019-2497-3

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, 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 Girardis, Oliver A CornelyStefano 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

IRCCS Fondazione Policlinico Universitario A. Gemelli

Research output: Contribution to journal › Article › peer-review

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 language	English
Pages (from-to)	219
Journal	Critical care (London, England)
Volume	23
Issue number	1
DOIs	https://doi.org/10.1186/s13054-019-2497-3
Publication status	Published - Jun 14 2019

Keywords

Aged
Candidiasis, Invasive/complications
Cross Infection/epidemiology
Europe/epidemiology
Female
Humans
Incidence
Intensive Care Units/organization & administration
Male
Middle Aged
Outcome Assessment, Health Care/methods
Retrospective Studies
Risk Factors

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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., ... Montravers, P. (2019). Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project. Critical care (London, England), 23(1), 219. https://doi.org/10.1186/s13054-019-2497-3

Bassetti, M, Giacobbe, DR, Vena, A, Trucchi, C, Ansaldi, F, Antonelli, M, Adamkova, V, Alicino, C, Almyroudi, M-P, Atchade, E, Azzini, AM, Carannante, N, Carnelutti, A, Corcione, S, Cortegiani, A, Dimopoulos, G, Dubler, S, García-Garmendia, JL, Girardis, M, Cornely, OA, Ianniruberto, S, Kullberg, BJ, Lagrou, K, Le Bihan, C, Luzzati, R, Malbrain, MLNG, Merelli, M, Marques, AJ, Martin-Loeches, I, Mesini, A, Paiva, J-A, Peghin, M, Raineri, SM, Rautemaa-Richardson, R, Schouten, J, Brugnaro, P, Spapen, H, Tasioudis, P, Timsit, J-F, Tisa, V, Tumbarello, M, van den Berg, CHSB, Veber, B, Venditti, M, Voiriot, G, Wauters, J & Montravers, P 2019, 'Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project', Critical care (London, England), vol. 23, no. 1, pp. 219. https://doi.org/10.1186/s13054-019-2497-3

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title = "Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project",

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.",

keywords = "Aged, Candidiasis, Invasive/complications, Cross Infection/epidemiology, Europe/epidemiology, Female, Humans, Incidence, Intensive Care Units/organization & administration, Male, Middle Aged, Outcome Assessment, Health Care/methods, Retrospective Studies, Risk Factors",

author = "Matteo Bassetti and Giacobbe, {Daniele R} and Antonio Vena and Cecilia Trucchi and Filippo Ansaldi and Massimo Antonelli and Vaclava Adamkova and Cristiano Alicino and Maria-Panagiota Almyroudi and Enora Atchade and Azzini, {Anna M} and Novella Carannante and Alessia Carnelutti and Silvia Corcione and Andrea Cortegiani and George Dimopoulos and Simon Dubler and Garc{\'i}a-Garmendia, {Jos{\'e} L} and Massimo Girardis and Cornely, {Oliver A} and Stefano Ianniruberto and Kullberg, {Bart Jan} and Katrien Lagrou and {Le Bihan}, Clement and Roberto Luzzati and Malbrain, {Manu L N G} and Maria Merelli and Marques, {Ana J} and Ignacio Martin-Loeches and Alessio Mesini and Jos{\'e}-Artur Paiva and Maddalena Peghin and Raineri, {Santi Maurizio} and Riina Rautemaa-Richardson and Jeroen Schouten and Pierluigi Brugnaro and Herbert Spapen and Polychronis Tasioudis and Jean-Fran{\c c}ois Timsit and Valentino Tisa and Mario Tumbarello and {van den Berg}, {Charlotte H S B} and Benoit Veber and Mario Venditti and Guillaume Voiriot and Joost Wauters and Philippe Montravers",

year = "2019",

month = jun,

day = "14",

doi = "10.1186/s13054-019-2497-3",

language = "English",

volume = "23",

pages = "219",

journal = "Critical Care",

issn = "1466-609X",

publisher = "Springer Science + Business Media",

number = "1",

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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 -

Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

Abstract

Keywords

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