In: Critical Care, 23 (2019), Nr. 219. pp. 1-7. ISSN 1466-609X

PDF, English - main document Download (669kB) | Lizenz: Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project by 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 underlies the terms of Creative Commons Attribution 4.0

Abstract

Background: The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe.

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.