EQUAL candida score can predict the prognosis of candidemia at a single center study.

INTRODUCTION

Despite the advance in diagnostic testing and antifungal therapy, candidemia remains still a life-threatening infectious disease. While the European Confederation of Medical Mycology proposed the European Confederation of Medical Mycology Quality of Clinical Candidemia Management (EQUAL) Candida score in 2018, its efficacy and validity are still discussing.

PATIENTS AND

METHODS

We reviewed all patients with candidemia during 2018-2023 to analyze the efficacy and validity of the EQUAL Candida score for predicting the outcome of candidemia.

RESULTS

A total of 159 patients were enrolled in the study. The EQUAL Candida scores were higher in survival group than death group for 30-day mortality (13.4 vs. 10.6, p < 0.001). As for cases with central venous catheter (CVC), the score was higher in survival group than in death group (14.3 vs. 11.2, p < 0.001). In terms of cases without CVC, survival group showed higher EQUAL Candida scores than death group (11.6 vs. 9.1, p < 0.001). The appropriate cut-off for predicting the 30-day mortality was 10 and was chosen based on the Youden Index. We found that higher SOFA score (≥5), higher CCI score (≥3), higher EQUAL Candida score (≥10), and catheter related blood stream infection were prognostic factors for 30-day mortality among patients with candidemia. Of these 4, Cox hazard model showed that higher SOFA score (≥5), higher CCI score (≥3) and higher EQUAL Candida score (≥10) were independent prognostic factors for 30-day mortality among them.

CONCLUSION

The EQUAL Candida score can predict the outcome of candidemia with and without CVC.