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

Research output: Contribution to journalArticlepeer-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 languageEnglish
Pages (from-to)219
JournalCritical care (London, England)
Volume23
Issue number1
DOIs
Publication statusPublished - 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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