Bassetti, Matteo, Vena, Antonio, Giacobbe, Daniele R., Trucchi, Cecilia, Ansaldi, Filippo, Antonelli, Massimo, Adamkova, Vaclava, Alicino, Cristiano, Almyroudi, Maria-Panagiota, Atchade, Enora, Azzini, Anna M., Brugnaro, Pierluigi, Carannante, Novella, Peghin, Maddalena, Berruti, Marco, Carnelutti, Alessia, Castaldo, Nadia, Corcione, Silvia, Cortegiani, Andrea ORCID: 0000-0003-1416-9993, Dimopoulos, George, Dubler, Simon, Garcia-Garmendia, Jose L., Girardis, Massimo, Cornely, Oliver A. ORCID: 0000-0001-9599-3137, Ianniruberto, Stefano, Kullberg, Bart Jan, Lagrou, Katrien, Lebihan, Clement, Luzzati, Roberto, Malbrain, Manu ORCID: 0000-0002-1816-5255, Merelli, Maria, Marques, Ana J., Martin-Loeches, Ignacio, Mesini, Alessio, Paiva, Jose-Artur, Raineri, Santi Maurizio, Rautemaa-Richardson, Riina, Schouten, Jeroen, Spapen, Herbert, Tasioudis, Polychronis, Timsit, Jean-Francois, Tisa, Valentino, Tumbarello, Mario, Van den Berg, Charlotte H. S. B., Veber, Benoit, Venditti, Mario, Voiriot, Guillaume, Wauters, Joost, Zappella, Nathalie and Montravers, Philippe (2022). Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study. Infect. Dis. Ther., 11 (2). S. 827 - 841. LONDON: SPRINGER LONDON LTD. ISSN 2193-6382

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Abstract

Introduction Intra-abdominal infections represent the second most frequently acquired infection in the intensive care unit (ICU), with mortality rates ranging from 20% to 50%. Candida spp. may be responsible for up to 10-30% of cases. This study assesses risk factors for development of intra-abdominal candidiasis (IAC) among patients admitted to ICU. Methods We performed a case-control study in 26 European ICUs during the period January 2015-December 2016. Patients at least 18 years old who developed an episode of microbiologically documented IAC during their stay in the ICU (at least 48 h after admission) served as the case cohort. The control group consisted of adult patients who did not develop episodes of IAC during ICU admission. Matching was performed at a ratio of 1:1 according to time at risk (i.e. controls had to have at least the same length of ICU stay as their matched cases prior to IAC onset), ICU ward and period of study. Results During the study period, 101 case patients with a diagnosis of IAC were included in the study. On univariate analysis, severe hepatic failure, prior receipt of antibiotics, prior receipt of parenteral nutrition, abdominal drain, prior bacterial infection, anastomotic leakage, recurrent gastrointestinal perforation, prior receipt of antifungal drugs and higher median number of abdominal surgical interventions were associated with IAC development. On multivariate analysis, recurrent gastrointestinal perforation (OR 13.90; 95% CI 2.65-72.82, p = 0.002), anastomotic leakage (OR 6.61; 95% CI 1.98-21.99, p = 0.002), abdominal drain (OR 6.58; 95% CI 1.73-25.06, p = 0.006), prior receipt of antifungal drugs (OR 4.26; 95% CI 1.04-17.46, p = 0.04) or antibiotics (OR 3.78; 95% CI 1.32-10.52, p = 0.01) were independently associated with IAC. Conclusions Gastrointestinal perforation, anastomotic leakage, abdominal drain and prior receipt of antifungals or antibiotics may help to identify critically ill patients with higher probability of developing IAC. Prospective studies are needed to identify which patients will benefit from early antifungal treatment.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Bassetti, MatteoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vena, AntonioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Giacobbe, Daniele R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Trucchi, CeciliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ansaldi, FilippoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Antonelli, MassimoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Adamkova, VaclavaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Alicino, CristianoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Almyroudi, Maria-PanagiotaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Atchade, EnoraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Azzini, Anna M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brugnaro, PierluigiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Carannante, NovellaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Peghin, MaddalenaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berruti, MarcoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Carnelutti, AlessiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Castaldo, NadiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Corcione, SilviaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cortegiani, AndreaUNSPECIFIEDorcid.org/0000-0003-1416-9993UNSPECIFIED
Dimopoulos, GeorgeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dubler, SimonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Garcia-Garmendia, Jose L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Girardis, MassimoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cornely, Oliver A.UNSPECIFIEDorcid.org/0000-0001-9599-3137UNSPECIFIED
Ianniruberto, StefanoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kullberg, Bart JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lagrou, KatrienUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lebihan, ClementUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Luzzati, RobertoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Malbrain, ManuUNSPECIFIEDorcid.org/0000-0002-1816-5255UNSPECIFIED
Merelli, MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Marques, Ana J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Martin-Loeches, IgnacioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mesini, AlessioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Paiva, Jose-ArturUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Raineri, Santi MaurizioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rautemaa-Richardson, RiinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schouten, JeroenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spapen, HerbertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tasioudis, PolychronisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Timsit, Jean-FrancoisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tisa, ValentinoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tumbarello, MarioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Van den Berg, Charlotte H. S. B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Veber, BenoitUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Venditti, MarioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Voiriot, GuillaumeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wauters, JoostUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zappella, NathalieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Montravers, PhilippeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-699207
DOI: 10.1007/s40121-021-00585-6
Journal or Publication Title: Infect. Dis. Ther.
Volume: 11
Number: 2
Page Range: S. 827 - 841
Date: 2022
Publisher: SPRINGER LONDON LTD
Place of Publication: LONDON
ISSN: 2193-6382
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CRITICALLY III PATIENTS; CONTROLLED-TRIAL; INFECTIONS; PREDICTORS; CANDIDEMIA; EPIDEMIOLOGY; CASPOFUNGIN; MANAGEMENT; MORTALITY; CONSENSUSMultiple languages
Infectious DiseasesMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69920

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