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)

L. Klingspor, A. M. Tortorano, J. Peman, B. Willinger, P. Hamal, B. Sendid, A. Velegraki, C. Kibbler, J. F. Meis, R. Sabino, M. Ruhnke, S. Arikan-Akdagli, J. Salonen, I. Dóczi

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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

Original languageEnglish
Pages (from-to)87.e1-87.e10
JournalClinical Microbiology and Infection
Volume21
Issue number1
DOIs
Publication statusPublished - 2015

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Mycology
Candida
Invasive Candidiasis
Intensive Care Units
Infection
Candida glabrata
Neurosurgery
caspofungin
Mortality
Candidemia
Candida tropicalis
Central Venous Catheters
Fluconazole
Multiple Trauma
Candida albicans
Multicenter Studies
Observational Studies
Surveys and Questionnaires
Adrenal Cortex Hormones
Thorax

Keywords

  • Candida
  • Candidaemia
  • Epidemiology
  • Invasive candidosis
  • Surgical intensive care

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

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). / Klingspor, L.; Tortorano, A. M.; Peman, J.; Willinger, B.; Hamal, P.; Sendid, B.; Velegraki, A.; Kibbler, C.; Meis, J. F.; Sabino, R.; Ruhnke, M.; Arikan-Akdagli, S.; Salonen, J.; Dóczi, I.

In: Clinical Microbiology and Infection, Vol. 21, No. 1, 2015, p. 87.e1-87.e10.

Research output: Contribution to journalArticle

Klingspor, L, Tortorano, AM, Peman, J, Willinger, B, Hamal, P, Sendid, B, Velegraki, A, Kibbler, C, Meis, JF, Sabino, R, Ruhnke, M, Arikan-Akdagli, S, Salonen, J & Dóczi, I 2015, '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)', Clinical Microbiology and Infection, vol. 21, no. 1, pp. 87.e1-87.e10. https://doi.org/10.1016/j.cmi.2014.08.011
Klingspor, L. ; Tortorano, A. M. ; Peman, J. ; Willinger, B. ; Hamal, P. ; Sendid, B. ; Velegraki, A. ; Kibbler, C. ; Meis, J. F. ; Sabino, R. ; Ruhnke, M. ; Arikan-Akdagli, S. ; Salonen, J. ; Dóczi, I. / 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). In: Clinical Microbiology and Infection. 2015 ; Vol. 21, No. 1. pp. 87.e1-87.e10.
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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",
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AU - Willinger, B.

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AU - Sendid, B.

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AU - Kibbler, C.

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