Publication
Invasive Candida infections in surgical patients in intensive care units: a prospective, multicentre survey initiated by the European Confederation of Medical Mycology (ECMM) (2006–2008)
| dc.contributor.author | Klingspor, L. | |
| dc.contributor.author | Tortorano, A.M. | |
| dc.contributor.author | Peman, J. | |
| dc.contributor.author | Willinger, B. | |
| dc.contributor.author | Hamal, P. | |
| dc.contributor.author | Sendid, B. | |
| dc.contributor.author | Velegraki, A. | |
| dc.contributor.author | Kibbler, C. | |
| dc.contributor.author | Meis, J.F. | |
| dc.contributor.author | Sabino, Raquel | |
| dc.contributor.author | Ruhnke, M. | |
| dc.contributor.author | Arikan-Akdagli, S. | |
| dc.contributor.author | Salonen, J. | |
| dc.contributor.author | Dóczi, I. | |
| dc.date.accessioned | 2016-02-16T18:10:37Z | |
| dc.date.available | 2016-03-01T01:30:08Z | |
| dc.date.issued | 2015-01-21 | |
| dc.description.abstract | A prospective, observational, multicentre study of invasive candidosis (IC) in surgical patients in intensive care units (ICUs) was conducted from 2006 to 2008 in 72 ICUs in 14 European countries. A total of 779 patients (62.5% males, median age 63 years) with IC were included. The median rate of candidaemia was 9 per 1000 admissions. In 10.8% the infection was already present at the time of admission to ICU. Candida albicans accounted for 54% of the isolates, followed by Candida parapsilosis 18.5%, Candida glabrata 13.8%, Candida tropicalis 6%, Candida krusei 2.5%, and other species 5.3%. Infections due to C. krusei (57.9%) and C. glabrata (43.6%) had the highest crude mortality rate. The most common preceding surgery was abdominal (51.5%), followed by thoracic (20%) and neurosurgery (8.2%). Candida glabrata was more often isolated after abdominal surgery in patients ≥60 years, and C. parapsilosis was more often isolated in neurosurgery and multiple trauma patients as well as children ≤1 year of age. The most common first-line treatment was fluconazole (60%), followed by caspofungin (18.7%), liposomal amphotericin B (13%), voriconazole (4.8%) and other drugs (3.5%). Mortality in surgical patients with IC in ICU was 38.8%. Multivariate analysis showed that factors independently associated with mortality were: patient age ≥60 years (hazard ratio (HR) 1.9, p 0.001), central venous catheter (HR 1.8, p 0.05), corticosteroids (HR 1.5, p 0.03), not receiving systemic antifungal treatment for IC (HR 2.8, p <0.0001), and not removing intravascular lines (HR 1.6, p 0.02). | pt_PT |
| dc.description.sponsorship | This study was supported by an unrestricted grant from Merck, Sharp & Dohme, USA. We are grateful to all investigators (the ECMM study group) for participating in this study. We also thank Yen Ngo (Stockholm, Sweden) for statistical analysis. | pt_PT |
| dc.identifier.citation | Clin Microbiol Infect. 2015 Jan;21(1):87.e1-87.e10. doi: 10.1016/j.cmi.2014.08.011. Epub 2014 Oct 12. | pt_PT |
| dc.identifier.doi | 10.1016/j.cmi.2014.08.011 | pt_PT |
| dc.identifier.issn | 1198-743X | |
| dc.identifier.uri | http://hdl.handle.net/10400.18/3353 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Elsevier/ European Society of Clinical Microbiology and Infectious Diseases | pt_PT |
| dc.relation.publisherversion | http://www.sciencedirect.com/science/article/pii/S1198743X14000184 | pt_PT |
| dc.subject | Candidemia | pt_PT |
| dc.subject | Surgical Patients | pt_PT |
| dc.subject | Intensive Care Units | pt_PT |
| dc.subject | Candidaemia | pt_PT |
| dc.subject | Epidemiology | pt_PT |
| dc.subject | Invasive Candidosis | pt_PT |
| dc.subject | Surgical Intensive Care | pt_PT |
| dc.subject | Infeções Parasitárias e Fúngicas | pt_PT |
| dc.title | Invasive Candida infections in surgical patients in intensive care units: a prospective, multicentre survey initiated by the European Confederation of Medical Mycology (ECMM) (2006–2008) | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 87.e10 | pt_PT |
| oaire.citation.startPage | 87.e1 | pt_PT |
| oaire.citation.title | Clinical Microbiology and Infection | pt_PT |
| oaire.citation.volume | 21(1) | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |