ArticleAntimicrobial agents and chemotherapy2005
Delaying the empiric treatment of candida bloodstream infection until positive blood culture results are obtained: a potential risk factor for hospital mortality.
Article in Antimicrobial agents and chemotherapy, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 467 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Web-based Structured Survey of Retrospective Data of Invasive Mycosis in Intensive Care Patients in Berlin - Brandenburg
Performance of the Dosage of Plasma 1, 3-β-D-glucan (BDG) for the Diagnosis of Candidemia in Intensive Care Patients: A Prospective, Multicenter Study
Who cites it
467 citing papers in PubMed, 2 syntheses or guidelines pooled it, 1,268 citations in OpenAlex.
- (1→3)-β-D-glucan testing for the detection of invasive fungal infections in immunocompromised or critically ill people.The Cochrane database of systematic reviews · 2020Pooled it
- Microbiological Laboratory Testing in the Diagnosis of Fungal Infections in Pulmonary and Critical Care Practice. An Official American Thoracic Society Clinical Practice Guideline.American journal of respiratory and critical care medicine · 2019Guideline
- Diagnostic performance of β-(1→3)-D-glucan, twoJournal of clinical microbiology · 2026Trial
- Treatment Outcomes Among Patients With a Positive Candida Culture Close to Randomization Receiving Rezafungin or Caspofungin in the ReSTORE Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Trial
- A Synthetic β-Mannan Epitope Enables Immunization and Detection of Candida auris.Angewandte Chemie (International ed. in English) · 2026Article
- Second-Order Chemometric Classification ofACS omega · 2026Article
- The future of fungal diagnostics: What's next in laboratory testing for invasive fungal infection?Medical mycology · 2026Review
- Therapeutic Failure in Invasive Fungal Infections: Beyond Antifungal Resistance-A Narrative Review.Journal of fungi (Basel, Switzerland) · 2026Review
- From Oral Candidiasis to Candidemia: A Review of Superficial to Invasive Progression.MicrobiologyOpen · 2026Review
- Persistence, Source Control, and Secondary Bacterial Bloodstream Infection in Catheter-Related Candidemia: A Retrospective Cohort Study.Journal of fungi (Basel, Switzerland) · 2026Article
- Diagnostic Failure in Invasive Fungal Infections: Causes, Clinical Consequences, and Mitigation Strategies.Journal of fungi (Basel, Switzerland) · 2026Review
- Clinical Outcomes ofJournal of fungi (Basel, Switzerland) · 2026Article
- Quantitative real-time PCR in the diagnosis of opportunistic infections in immunocompromised patients: Diagnostic performance, clinical utility, and future directions.Infectious diseases & immunity · 2026Review
- From Species Identification to Empirical Therapy: A Machine Learning and Rule-Based Decision Support Framework for Antifungal Resistance Prediction in ICUMedical sciences (Basel, Switzerland) · 2026Article
- Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026.Intensive care medicine · 2026Article
- Mesenchymal Stem Cells in Fungal Infections: Immunomodulation, Direct Antifungal Activity, and the Promise of the Secretome.Biomedicines · 2026Review
- Predictive Utility of the Pediatric-EQUAL Scale in Pediatric Candidemia Admitted to PICU Association with Clinical and Microbiological Factors Related Mortality.Infectious diseases and therapy · 2026Article
- Mortality ofJournal of fungi (Basel, Switzerland) · 2026Article
- Two-step deep-learning candidemia prediction model using two large time-sequence electronic health datasets.medRxiv : the preprint server for health sciences · 2026Article
- Article
407 more citing papers are in PubMed but not listed here.
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Fungal bloodstream infections are associated with significant patient mortality and health care costs. Nevertheless, the relationship between a delay of the initial empiric antifungal treatment until blood culture results are known and the clinical outcome is not well established. A retrospective cohort analysis with automated patient medical records and the pharmacy database at Barnes-Jewish Hospital was conducted. One hundred fifty-seven patients with a Candida bloodstream infection were identified over a 4-year period (January 2001 through December 2004). Fifty (31.8%) patients died during hospitalization. One hundred thirty-four patients had empiric antifungal treatment begun after the results of fungal cultures were known. From the time that the first blood sample for culture that was positive was drawn, 9 (5.7%) patients received antifungal treatment within 12 h, 10 (6.4%) patients received antifungal treatment between 12 and 24 h, 86 (54.8%) patients received antifungal treatment between 24 and 48 h, and 52 (33.1%) patients received antifungal treatment after 48 h. Multiple logistic regression analysis identified Acute Physiology and Chronic Health Evaluation II scores (one-point increments) (adjusted odds ratio [AOR], 1.24; 95% confidence interval [CI], 1.18 to 1.31; P < 0.001), prior antibiotic treatment (AOR, 4.05; 95% CI, 2.14 to 7.65; P = 0.028), and administration of antifungal treatment 12 h after having the first positive blood sample for culture (AOR, 2.09; 95% CI, 1.53 to 2.84; P = 0.018) as independent determinants of hospital mortality. Administration of empiric antifungal treatment 12 h after a positive blood sample for culture is drawn is common among patients with Candida bloodstream infections and is associated with greater hospital mortality. Delayed treatment of Candida bloodstream infections could be minimized by the development of more rapid diagnostic techniques for the identification of Candida bloodstream infections. Alternatively, increased use of empiric antifungal treatment in selected patients at high risk for fungal bloodstream infection could also reduce delays in treatment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.