Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project.
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Bassetti Matteo, Giacobbe Daniele R, Vena Antonio, Trucchi Cecilia, Ansaldi Filippo, Antonelli Massimo, Adamkova Vaclava, Alicino Cristiano, Almyroudi Maria-Panagiota, Atchade Enora, Azzini Anna M, Carannante Novella, Carnelutti Alessia, Corcione Silvia, Cortegiani Andrea, Dimopoulos George, Dubler Simon, García-Garmendia José L, Girardis Massimo, Cornely Oliver A, Ianniruberto Stefano, Kullberg Bart Jan, Lagrou Katrien, Le Bihan Clement, Luzzati Roberto, Malbrain Manu L N G, Merelli Maria, Marques Ana J, Martin-Loeches Ignacio, Mesini Alessio, Paiva José-Artur, Peghin Maddalena, Raineri Santi Maurizio, Rautemaa-Richardson Riina, Schouten Jeroen, Brugnaro Pierluigi, Spapen Herbert, Tasioudis Polychronis, Timsit Jean-François, Tisa Valentino, Tumbarello Mario, van den Berg Charlotte H S B, Veber Benoit, Venditti Mario, Voiriot Guillaume, Wauters Joost, Montravers Philippe
Аннотация
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.