Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study

Andrea Cortegiani, Santi Maurizio Raineri, Joost Wauters, Guillaume Voiriot, Katrien Lagrou, Ignacio Martin-Loeches, Anna M. Azzini, Philippe Montravers, Cristiano Alicino, Jean-François Timsit, Antonio Vena, Alessio Mesini, Daniele R. Giacobbe, Cecilia Trucchi, Alessia Carnelutti, Silvia Corcione, Nathalie Zappella, Maria Merelli, George Dimopoulos, Maria-Panagiota AlmyroudiAndrea Cortegiani, Mario Tumbarello, Roberto Luzzati, Nadia Castaldo, Jeroen Schouten, Vaclava Adamkova, Enora Atchade, Clement Lebihan, Valentino Tisa, Simon Dubler, Matteo Bassetti, Polychronis Tasioudis, Stefano Ianniruberto, Marco Berruti, Ana J. Marques, Riina Rautemaa-Richardson, Novella Carannante, Pierluigi Brugnaro, Maddalena Peghin, Santi Maurizio Raineri, Filippo Ansaldi, Massimo Girardis, José L. García-Garmendia, Manu Malbrain, Oliver A. Cornely, Benoit Veber, Mario Venditti, Bart Jan Kullberg, Herbert Spapen, Massimo Antonelli, José-Artur Paiva, Charlotte H. S. B. Van Den Berg

Risultato della ricerca: Articlepeer review

1 Citazioni (Scopus)

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.
Lingua originaleEnglish
Numero di pagine14
RivistaInfectious Diseases and Therapy
Stato di pubblicazionePublished - 2022

All Science Journal Classification (ASJC) codes

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