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Guideline adherence and survival of patients with candidaemia in Europe: results from the ECMM Candida III multinational European observational cohort study
M. Hoenigl, J. Salmanton-García, M. Egger, JP. Gangneux, T. Bicanic, S. Arikan-Akdagli, A. Alastruey-Izquierdo, N. Klimko, A. Barac, V. Özenci, EFJ. Meijer, N. Khanna, M. Bassetti, R. Rautemaa-Richardson, K. Lagrou, KM. Adam, EH. Akalin, M....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu pozorovací studie, časopisecké články, práce podpořená grantem
NLK
ProQuest Central
od 2001-08-01 do Před 2 měsíci
Nursing & Allied Health Database (ProQuest)
od 2001-08-01 do Před 2 měsíci
Health & Medicine (ProQuest)
od 2001-08-01 do Před 2 měsíci
Public Health Database (ProQuest)
od 2001-08-01 do Před 2 měsíci
- MeSH
- antifungální látky terapeutické užití MeSH
- Candida * MeSH
- dodržování směrnic MeSH
- dospělí MeSH
- kandidemie * farmakoterapie epidemiologie mikrobiologie MeSH
- kohortové studie MeSH
- lidé MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
BACKGROUND: The European Confederation of Medical Mycology (ECMM) collected data on epidemiology, risk factors, treatment, and outcomes of patients with culture-proven candidaemia across Europe to assess how adherence to guideline recommendations is associated with outcomes. METHODS: In this observational cohort study, 64 participating hospitals located in 20 European countries, with the number of eligible hospitals per country determined by population size, included the first ten consecutive adults with culture-proven candidaemia after July 1, 2018, and entered data into the ECMM Candida Registry (FungiScope CandiReg). We assessed ECMM Quality of Clinical Candidaemia Management (EQUAL Candida) scores reflecting adherence to recommendations of the European Society of Clinical Microbiology and Infectious Diseases and the Infectious Diseases Society of America guidelines. FINDINGS: 632 patients with candidaemia were included from 64 institutions. Overall 90-day mortality was 43% (265/617), and increasing age, intensive care unit admission, point increases in the Charlson comorbidity index score, and Candida tropicalis as causative pathogen were independent baseline predictors of mortality in Cox regression analysis. EQUAL Candida score remained an independent predictor of mortality in the multivariable Cox regression analyses after adjusting for the baseline predictors, even after restricting the analysis to patients who survived for more than 7 days after diagnosis (adjusted hazard ratio 1·08 [95% CI 1·04-1·11; p<0·0001] in patients with a central venous catheter and 1·09 [1·05-1·13; p<0·0001] in those without one, per one score point decrease). Median duration of hospital stay was 15 days (IQR 4-30) after diagnosis of candidaemia and was extended specifically for completion of parenteral therapy in 100 (16%) of 621 patients. Initial echinocandin treatment was associated with lower overall mortality and longer duration of hospital stay among survivors than treatment with other antifungals. INTERPRETATION: Although overall mortality in patients with candidaemia was high, our study indicates that adherence to clinical guideline recommendations, reflected by higher EQUAL Candida scores, might increase survival. New antifungals, with similar activity as current echinocandins but with longer half-lives or oral bioavailability, are needed to reduce duration of hospital stay. FUNDING: Scynexis.
Belfast Health and Social Care Trust Belfast UK
Center of Expertise in Mycology Radboudumc CWZ Nijmegen Netherlands
Centre for Microbiology Institute of Public Health of Vojvodina Novi Sad Serbia
Centre for Molecular Medicine Cologne University of Cologne Cologne Germany
Centre for Trials Research and Division of Infection and Immunity Cardiff University Cardiff UK
Centre Hospitalier de Versailles Hématologie Le Chesnay France
Centro de Investigación Biomédica en Red de Enfermedades Infecciosas Madrid Spain
Clinical Trials Centre Cologne University of Cologne Cologne Germany
Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
Department of Clinical Microbiology Karolinska University Hospital Stockholm Sweden
Department of Clinical Microbiology Rigshospitalet Copenhagen Denmark
Department of Clinical Microbiology University Hospitals of Leicester NHS Trust Leicester UK
Department of Health Sciences University of Genoa Genoa Italy
Department of Hematology Amsterdam University Medical Centers Amsterdam Netherlands
Department of Infection Guy's and St Thomas' NHS Foundation Trust London UK
Department of Infectious Diseases Hospital Clínic de Barcelona Barcelona Spain
Department of Infectious Diseases Karolinska University Hospital Stockholm Sweden
Department of Laboratory Medicine and National Reference Center for Mycosis UZ Leuven Leuven Belgium
Department of Medical Microbiology Aberdeen Royal Infirmary Foresterhill Aberdeen UK
Department of Medical Microbiology Hacettepe University Medical School Ankara Türkiye
Department of Medical Microbiology Radboud University Medical Center Nijmegen Netherlands
Department of Oncohematology Comenius University and National Cancer Institute Bratislava Slovakia
Department of Public Health Microbiology and Virology Università degli Studi di Milano Milan Italy
Division of Nephrology and Infectious Diseases AZ Sint Jan Brugge Oostende AV Brugge Belgium
Faculty of Medicine and University Hospital Cologne University of Cologne Cologne Germany
German Centre for Infection Research Partner Site Bonn Cologne Cologne Germany
Hospital Nuestra Señora de Sonsoles Ávila Spain
Infectious Diseases Unit IRCCS Ospedale Policlinico San Martino Genoa Italy
Institute of Infection and Immunity St George's University of London London UK
Medical Research Council Clinical Trials Unit University College London London UK
Microbiology Department La Paz University Hospital Madrid Spain
Microbiology Division Public Health Wales Cardiff UK
Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK
Northumbria Healthcare NHS Foundation Trust North Shields UK
Paris Cité Université Necker Hospital Assistance Publique Hôpitaux de Paris Paris France
Unit of Mycology Statens Serum Institut Copenhagen Denmark
Univ Rennes CHU Rennes Inserm EHESP Irset UMR_S 1085 Rennes France
Citace poskytuje Crossref.org
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- $a Hoenigl, Martin $u Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria; Translational Medical Mycology Research Unit, European Confederation of Medical Mycology Excellence Center for Medical Mycology, Medical University of Graz, Graz, Austria; BioTechMed, Graz, Austria. Electronic address: hoeniglmartin@gmail.com
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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