Temporal trends, risk factors and outcomes in albicans and non-albicans candidaemia: an international epidemiological study in four multidisciplinary intensive care units

Holley, Anthony, Dulhunty, Joel, Blot, Stijn, Lipman, Jeffrey, Lobo, Suzana, Dancer, Craig, Rello, Jordi and Dimopoulos, George (2009) Temporal trends, risk factors and outcomes in albicans and non-albicans candidaemia: an international epidemiological study in four multidisciplinary intensive care units. International Journal of Antimicrobial Agents, 33 6: 554.e1-554.e7. doi:10.1016/j.ijantimicag.2008.10.035


Author Holley, Anthony
Dulhunty, Joel
Blot, Stijn
Lipman, Jeffrey
Lobo, Suzana
Dancer, Craig
Rello, Jordi
Dimopoulos, George
Title Temporal trends, risk factors and outcomes in albicans and non-albicans candidaemia: an international epidemiological study in four multidisciplinary intensive care units
Formatted title
Temporal trends, risk factors and outcomes in albicans and non-albicans candidaemia: an international epidemiological study in four multidisciplinary intensive care units
Journal name International Journal of Antimicrobial Agents   Check publisher's open access policy
ISSN 0924-8579
1872-7913
Publication date 2009-06-01
Year available 2009
Sub-type Article (original research)
DOI 10.1016/j.ijantimicag.2008.10.035
Open Access Status Not yet assessed
Volume 33
Issue 6
Start page 554.e1
End page 554.e7
Total pages 7
Editor A.M. Geddes
Place of publication Maryland Heights, MO, United States
Publisher Elsevier
Language eng
Subject C1
Abstract This multicentre study (i) evaluated geographic and temporal changes in candidaemia ecology in the critically ill, (ii) identified risk factors associated with non-albicans candidaemia and (iii) examined the association of Candida ecology with mortality. A retrospective cohort study of patients who developed candidaemia in four general Intensive Care Units located in Australia, Greece, Belgium and Brazil was performed. Two hundred Candida organisms were identified by positive blood culture in 189 patients, including 112 Candida albicans (56.0%), 38 Candida glabrata (19.0%), 21 Candida parapsilosis (10.5%), 18 Candida tropicalis (9.0%), 6 Candida krusei (3.0%), 1 Candida famata (0.5%), 1 Candida zeylanoides (0.5%) and 3 non-differentiated Candida spp. (1.5%). No trend towards increased non-albicans species over the study period (P = 0.68) or by geographic area (P = 0.35) was demonstrated. Independent risk factors for non-albicans candidaemia included: female gender [odds ratio (OR) 2.09, 95% confidence interval (CI) 1.13-3.86] and increased central venous catheter days (OR 1.16 per 5-day interval, 95% CI 1.05-1.28). Mortality in the non-albicans group was non-significantly higher than in the albicans group (65% vs. 53%; P = 0.10). This study is unique in that a large number of intensive care candidaemias in four geographically diverse units have been studied. (C) 2009 Published by Elsevier B.V. and the International Society of Chemotherapy.
Formatted abstract
This multicentre study (i) evaluated geographic and temporal changes in candidaemia ecology in the critically ill, (ii) identified risk factors associated with non-albicans candidaemia and (iii) examined the association of Candida ecology with mortality. A retrospective cohort study of patients who developed candidaemia in four general Intensive Care Units located in Australia, Greece, Belgium and Brazil was
performed. Two hundred Candida organisms were identified by positive blood culture in 189 patients, including 112 Candida albicans (56.0%), 38 Candida glabrata (19.0%), 21 Candida parapsilosis (10.5%), 18 Candida tropicalis (9.0%), 6 Candida krusei (3.0%), 1 Candida famata (0.5%), 1 Candida zeylanoides (0.5%) and 3 non-differentiated Candida spp. (1.5%). No trend towards increased non-albicans species over the study period (P = 0.68) or by geographic area (P = 0.35) was demonstrated. Independent risk factors for non-albicans candidaemia included: female gender [odds ratio (OR) 2.09, 95% confidence interval (CI) 1.13–3.86] and increased central venous catheter days (OR 1.16 per 5-day interval, 95% CI 1.05–1.28). Mortality in the non-albicans group was non-significantly higher than in the albicans group (65% vs. 53%; P = 0.10). This study is unique in that a large number of intensive care candidaemias in four geographically diverse units have been studied.
Keyword Candida
Epidemiology
Fungaemia
Intensive care
Mortality
Trends
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
ERA 2012 Admin Only
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 22 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 39 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Thu, 03 Sep 2009, 18:06:50 EST by Mr Andrew Martlew on behalf of School of Medicine