Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

被引：168

作者：

Bassetti, Matteo ^{[1
,2
,3
]}

Giacobbe, Daniele R. ^{[3
]}

Vena, Antonio ^{[1
,2
]}

Trucchi, Cecilia ^{[4
,5
]}

Ansaldi, Filippo ^{[3
,4
,5
]}

Antonelli, Massimo ^{[6
]}

Adamkova, Vaclava ^{[7
,8
]}

Alicino, Cristiano ^{[3
,9
]}

Almyroudi, Maria-Panagiota ^{[10
]}

Atchade, Enora ^{[11
]}

Azzini, Anna M. ^{[12
]}

Carannante, Novella ^{[13
]}

Carnelutti, Alessia ^{[1
,2
]}

Corcione, Silvia ^{[14
]}

Cortegiani, Andrea ^{[15
]}

Dimopoulos, George ^{[10
]}

Dubler, Simon ^{[16
]}

Garcia-Garmendia, Jose L. ^{[17
]}

Girardis, Massimo ^{[18
]}

Cornely, Oliver A. ^{[19
,20
]}

Ianniruberto, Stefano ^{[21
]}

Kullberg, Bart Jan ^{[22
]}

Lagrou, Katrien ^{[23
,24
,25
]}

Le Bihan, Clement ^{[26
]}

Luzzati, Roberto ^{[27
]}

Malbrain, Manu L. N. G. ^{[28
,29
]}

Merelli, Maria ^{[1
,2
]}

Marques, Ana J. ^{[30
]}

Martin-Loeches, Ignacio ^{[31
,32
]}

Mesini, Alessio ^{[3
]}

Paiva, Jose-Artur ^{[33
]}

Peghin, Maddalena ^{[1
,2
]}

Raineri, Santi Maurizio ^{[34
]}

Rautemaa-Richardson, Riina ^{[35
,36
]}

Schouten, Jeroen ^{[22
]}

Brugnaro, Pierluigi ^{[37
]}

Spapen, Herbert ^{[38
]}

Tasioudis, Polychronis ^{[39
]}

Timsit, Jean-Francois ^{[40
,41
]}

Tisa, Valentino ^{[3
]}

Tumbarello, Mario ^{[42
]}

van den Berg, Charlotte H. S. B. ^{[43
]}

Veber, Benoit ^{[44
]}

Venditti, Mario ^{[45
]}

Voiriot, Guillaume ^{[46
]}

Wauters, Joost ^{[47
]}

Montravers, Philippe ^{[11
,48
]}

机构：

[1] Univ Udine, Dept Med, Infect Dis Clin, I-33100 Udine, Italy

[2] Santa Maria Misericordia Hosp, Piazzale Santa Maria Misericordia 15, I-33100 Udine, Italy

[3] Univ Genoa, Dept Hlth Sci, Genoa, Italy

[4] Azienda Ligure Sanit Regione Liguria ALiSa, Hlth Planning Unit, Genoa, Liguria Region, Italy

[5] Policlin San Martino Hosp, IRCCS, Hlth Planning Unit, Genoa, Italy

[6] Univ Cattolica Sacro Cuore, Fdn Policlin Univ Agostino Gemelli, Dept Intens Care & Anesthesiol, Rome, Italy

[7] Gen Univ Hosp, Inst Med Biochem & Lab Diagnost, Clin Microbiol & ATB Ctr, Prague, Czech Republic

[8] Palackeho Univ, Med Fac, Dept Med Microbiol, Olomouc, Czech Republic

[9] ASL 2 Reg Hlth Syst Liguria, Santa Corona Hosp, Med Direct, Pietra Ligure, Italy

[10] Univ Athens, Univ Hosp Attikon, Med Sch, Dept Crit Care, Athens, Greece

[11] CHU Bichat Claude Bernard, HUPNVS, AP HP, Dept Anesthesie Reanimat, Paris, France

[12] Univ Verona, Infect Dis Unit, Dept Diagnost & Publ Hlth, Verona, Italy

[13] AO Colli, Cotugno Hosp, Div 1, Naples, Italy

[14] Univ Turin, Infect Dis, Dept Med Sci, Turin, Italy

[15] Univ Palermo, Policlin Paolo Giaccone, Sect Anesthesia Analgesia Intens Care & Emergency, Dept Surg Oncol & Oral Sci Di Chir On S, Palermo, Italy

[16] Heidelberg Univ Hosp, Dept Anesthesiol & Intens Care Med, Heidelberg, Germany

[17] Hosp San Juan de Dios del Aljarafe, Serv Cuidados Criticos & Urgencias, Seville, Spain

[18] Univ Hosp Modena, Dept Anesthesia & Intens Care, Modena, Italy

[19] Univ Hosp Cologne, Dept Internal Med, Cologne, Germany

[20] Cologne Excellence Cluster Cellular Stress Respon, Cologne, Germany

[21] Univ Bologna, S Orsola Malpighi Hosp, Dept Med & Surg Sci, Infect Dis Unit, Bologna, Italy

[22] Radboud Univ Nijmegen, Med Ctr, Radboud Ctr Infect Dis, Nijmegen, Netherlands

[23] Univ Hosp Leuven, Dept Lab Med, Leuven, Belgium

[24] Univ Hosp Leuven, Natl Reference Ctr Mycosis, Leuven, Belgium

[25] Katholieke Univ Leuven, Dept Microbiol & Immunol, Leuven, Belgium

[26] Med ICU, Bichat Reanimat Med & Malad Infect, Paris, France

[27] Azienda Sanit Univ Integrata Trieste, Infect Dis Dept, Trieste, Italy

[28] Univ Hosp Brussels UZB, Dept Intens Care Med, Jette, Belgium

[29] VUB, Fac Med & Pharm, Brussels, Belgium

[30] CH Vila Nova De Gaia Espinho, Vila Nova De Gaia, Portugal

[31] St James Hosp, MICRO, Dept Intens Care Med, Dublin, Ireland

[32] Univ Barcelona, IDIBAPS, CIBERes, Hosp Clin, Barcelona, Spain

[33] Univ Porto, CHU Sao Joao, Fac Med, Dept Emergency & Intens Care Med, Porto, Portugal

[34] Univ Palermo, Policlin P Giaccone, Sect Anesthesia Analgesia Intens Care & Emergency, Dept Biopathol & Med Biotechnol, Palermo, Italy

[35] Manchester Univ NHS Fdn Trust, Wythenshawe Hosp, Dept Infect Dis, Manchester, Lancs, England

[36] Univ Manchester, Fac Biol Med & Hlth, Manchester, Lancs, England

[37] Osped Civile SS Giovanni & Paolo, Infect Dis Dept, Venice, Italy

[38] Univ Ziekenhuis Brussel UZ Brussel, VUB, Intens Care Dept, Brussels, Belgium

[39] G Gennimatas Gen Hosp Thessaloniki, Thessaloniki, Greece

[40] Univ Paris Diderot, Hop Bichat Reanimat Med & Malad Infect, Paris, France

[41] Univ Paris Diderot, Sorbonne Paris Cite, IAME Team 5 DeSCID Decis Sci Infect Dis Control &, INSERM,UMR 1137, Paris, France

[42] Univ Cattolica Sacro Cuore, Fdn Policlin Univ A Gemelli IRCCS, Inst Infect Dis, Rome, Italy

[43] Univ Med Ctr Groningen, Dept Intens Care, Groningen, Netherlands

[44] Rouen Univ Hosp, Pole Anesthesie Reanimat SAMU, Rouen, France

[45] Sapienza Univ Rome, Dept Publ Hlth & Infect Dis, Rome, Italy

[46] Sorbonne Univ, Hop Tenon, AP HP, Serv Reanimat Medicochirurg, F-75020 Paris, France

[47] Univ Hosp Leuven, Med Intens Care Unit, Dept Gen Internal Med, Leuven, Belgium

[48] Univ Paris, INSERM, UMR 1152, Paris, France

来源：

CRITICAL CARE | 2019年 / 23卷 / 1期

关键词：

ICU; Candidemia; Candidiasis; Candida; Abdominal candidiasis; Incidence; INTRAABDOMINAL CANDIDIASIS; EPIDEMIOLOGY; CANDIDEMIA; MULTICENTER; PREDICTORS; MANAGEMENT;

D O I：

10.1186/s13054-019-2497-3

中图分类号：

R4 [临床医学];

学科分类号：

100218 [急诊医学];

摘要：

BackgroundThe objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe.MethodsA 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).ResultsDuring 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.ConclusionsThe 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.

引用

页数：7

共 12 条

[1]

ICU-acquired candidaemia in France: Epidemiology and temporal trends, 2004-2013-A study from the REA-RAISIN network [J].

Baldesi, Olivier ;

Bailly, Sebastien ;

Ruckly, Stephane ;

Lepape, Alain ;

L'Heriteau, Francois ;

Aupee, Martine ;

Boussat, Sandrine ;

Bervas, Caroline ;

Machut, Anais ;

Berger-Carbonne, Anne ;

Savey, Anne ;

Timsit, Jean Francois .

JOURNAL OF INFECTION, 2017, 75 (01) :59-67

[2]

Clinical characteristics and predictors of mortality in cirrhotic patients with candidemia and intra-abdominal candidiasis: a multicenter study [J].

Bassetti, Matteo ;

Peghin, Maddalena ;

Carnelutti, Alessia ;

Righi, Elda ;

Merelli, Maria ;

Ansaldi, Filippo ;

Trucchi, Cecilia ;

Alicino, Cristiano ;

Sartor, Assunta ;

Toniutto, Pierluigi ;

Wauters, Joost ;

Laleman, Wim ;

Tascini, Carlo ;

Menichetti, Francesco ;

Luzzati, Roberto ;

Brugnaro, Pierluigi ;

Mesini, Alessio ;

Raviolo, Stefania ;

De Rosa, Francesco G. ;

Lagunes, Leonel ;

Rello, Jordi ;

Dimopoulos, George ;

Colombo, Arnaldo L. ;

Nucci, Marcio ;

Vena, Antonio ;

Bouza, Emilio ;

Munoz, Patricia ;

Tumbarello, Mario ;

Losito, Raffaella ;

Martin-Loeches, Ignacio ;

Viscoli, Claudio .

INTENSIVE CARE MEDICINE, 2017, 43 (04) :509-518

[3]

A multicenter multinational study of abdominal candidiasis: epidemiology, outcomes and predictors of mortality [J].

Bassetti, Matteo ;

Righi, Elda ;

Ansaldi, Filippo ;

Merelli, Maria ;

Scarparo, Claudio ;

Antonelli, Massimo ;

Garnacho-Montero, Jose ;

Diaz-Martin, Ana ;

Palacios-Garcia, Inmaculada ;

Luzzati, Roberto ;

Rosin, Chiara ;

Lagunes, Leonel ;

Rello, Jordi ;

Almirante, Benito ;

Scotton, Pier Giorgio ;

Baldin, Gianmaria ;

Dimopoulos, George ;

Nucci, Marcio ;

Munoz, Patricia ;

Vena, Antonio ;

Bouza, Emilio ;

de Egea, Viviana ;

Colombo, Arnaldo Lopes ;

Tascini, Carlo ;

Menichetti, Francesco ;

Tagliaferri, Enrico ;

Brugnaro, Pierluigi ;

Sanguinetti, Maurizio ;

Mesini, Alessio ;

Sganga, Gabriele ;

Viscoli, Claudio ;

Tumbarello, Mario .

INTENSIVE CARE MEDICINE, 2015, 41 (09) :1601-1610

[4]

A multicenter study of septic shock due to candidemia: outcomes and predictors of mortality [J].

Bassetti, Matteo ;

Righi, Elda ;

Ansaldi, Filippo ;

Merelli, Maria ;

Cecilia, Trucchi ;

De Pascale, Gennaro ;

Diaz-Martin, Ana ;

Luzzati, Roberto ;

Rosin, Chiara ;

Lagunes, Leonel ;

Trecarichi, Enrico Maria ;

Sanguinetti, Maurizio ;

Posteraro, Brunella ;

Garnacho-Montero, Jose ;

Sartor, Assunta ;

Rello, Jordi ;

Della Rocca, Giorgio ;

Antonelli, Massimo ;

Tumbarello, Mario .

INTENSIVE CARE MEDICINE, 2014, 40 (06) :839-845

[5]

A research agenda on the management of intra-abdominal candidiasis: results from a consensus of multinational experts [J].

Bassetti, Matteo ;

Marchetti, Monia ;

Chakrabarti, Arunaloke ;

Colizza, Sergio ;

Garnacho-Montero, Jose ;

Kett, Daniel H. ;

Munoz, Patricia ;

Cristini, Francesco ;

Andoniadou, Anastasia ;

Viale, Pierluigi ;

Della Rocca, Giorgio ;

Roilides, Emmanuel ;

Sganga, Gabriele ;

Walsh, Thomas J. ;

Tascini, Carlo ;

Tumbarello, Mario ;

Menichetti, Francesco ;

Righi, Elda ;

Eckmann, Christian ;

Viscoli, Claudio ;

Shorr, Andrew F. ;

Leroy, Olivier ;

Petrikos, George ;

De Rosa, Francesco Giuseppe .

INTENSIVE CARE MEDICINE, 2013, 39 (12) :2092-2106

[6]

Epidemiology of candidemia in intensive care units [J].

Bouza, Emilio ;

Munoz, Patricia .

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 2008, 32 :S87-S91

[7]

Management of invasive candidiasis and candidemia in adult non-neutropenic intensive care unit patients: Part I. Epidemiology and diagnosis [J].

Guery, Benoit P. ;

Arendrup, Maiken C. ;

Auzinger, Georg ;

Azoulay, Elie ;

Borges Sa, Marcio ;

Johnson, Elizabeth M. ;

Mueller, Eckhard ;

Putensen, Christian ;

Rotstein, Coleman ;

Sganga, Gabriele ;

Venditti, Mario ;

Zaragoza Crespo, Rafael ;

Kullberg, Bart Jan .

INTENSIVE CARE MEDICINE, 2009, 35 (01) :55-62

[8]

Candida bloodstream infections in intensive care units: Analysis of the extended prevalence of infection in intensive care unit study [J].

Kett, Daniel H. ;

Azoulay, Elie ;

Echeverria, Pablo M. ;

Vincent, Jean-Louis .

CRITICAL CARE MEDICINE, 2011, 39 (04) :665-670

[9]

Systemic antifungal therapy for proven or suspected invasive candidiasis: the AmarCAND 2 study [J].

Leroy, Olivier ;

Bailly, Sebastien ;

Gangneux, Jean-Pierre ;

Mira, Jean-Paul ;

Devos, Patrick ;

Dupont, Herve ;

Montravers, Philippe ;

Perrigault, Pierre-Francois ;

Constantin, Jean-Michel ;

Guillemot, Didier ;

Azoulay, Elie ;

Lortholary, Olivier ;

Bensoussan, Caroline ;

Timsit, Jean-Francois .

ANNALS OF INTENSIVE CARE, 2016, 6 :1-11

[10]

Characteristics and risk factors for 28-day mortality of hospital acquired fungemias in ICUs: data from the EUROBACT study [J].

Paiva, Jose-Artur ;

Pereira, Jose Manuel ;

Tabah, Alexis ;

Mikstacki, Adam ;

de Carvalho, Frederico Bruzzi ;

Koulenti, Despoina ;

Ruckly, Stephane ;

Cakar, Nahit ;

Misset, Benoit ;

Dimopoulos, George ;

Antonelli, Massimo ;

Rello, Jordi ;

Ma, Xiaochun ;

Tamowicz, Barbara ;

Timsit, Jean-Francois .

CRITICAL CARE, 2016, 20

← 1 2 →