Trial reportCanadian respiratory journal
Impact of Candida species on clinical outcomes in patients with suspected ventilator-associated pneumonia.
Trial report in Canadian respiratory journal. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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Who cites it
34 citing papers in PubMed.
- Candida in the respiratory tract secretions of critically ill patients and the impact of antifungal treatment: a randomized placebo controlled pilot trial (CANTREAT study).Intensive care medicine · 2014Trial
- No Survival Benefit Associated With Antifungal Therapy for RespiratoryOpen forum infectious diseases · 2026Article
- Next-generation Candida albicans vaccine VXV-01 containing recombinant Als3p and Hyr1p antigens for invasive Candida infections.Scientific reports · 2025Article
- Airway Candida diversity in COPD patients and its differential stimulatory effects on lung inflammation in mice.BMC pulmonary medicine · 2025Article
- Next-generation Candida albicans recombinant Als3p and Hyr1p dual antigen vaccine for invasive Candida infections.Research square · 2025Article
- Evaluation of theQatar medical journal · 2025Article
- Microbiological Diagnostic Performance and Clinical Effect of Metagenomic Next-Generation Sequencing for the Detection of Immunocompromised Patients With Community-Acquired Pneumonia.Infection and drug resistance · 2025Article
- Cerebrospinal Drain Infection byJournal of fungi (Basel, Switzerland) · 2024Review
- Isolation ofJournal of fungi (Basel, Switzerland) · 2024Article
- Efficacy of Ceragenins in Controlling the Growth of Oral Microorganisms: Implications for Oral Hygiene Management.Pharmaceuticals (Basel, Switzerland) · 2024Article
- Description of the colonizing mycobiota of endotracheal tubes from patients admitted to two intensive care units in Bogotá, ColombiaBiomedica : revista del Instituto Nacional de Salud · 2023Article
- Fungal Infections Identified with Multiplex PCR in Severe COVID-19 Patients during Six Pandemic Waves.Medicina (Kaunas, Lithuania) · 2023Article
- Positive sputum culture ofChinese medical journal pulmonary and critical care medicine · 2023Article
- COVID-19 Is a Confounder of IncreasedPathogens (Basel, Switzerland) · 2023Article
- Diagnostic Value and Clinical Application of Metagenomic Next-Generation Sequencing for Infections in Critically Ill Patients.Infection and drug resistance · 2023Article
- Risk Factors for Candida Infection among Children Admitted to a Pediatric Intensive Care Unit in a Tertiary Care Centre in Southern India.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- Clinical Implication ofInfection & chemotherapy · 2022Article
- Clinical impact of Candida respiratory tract colonization and acute lung infections in critically ill patients with COVID-19 pneumonia.Microbial pathogenesis · 2022Article
- Plasma 1,3-β-d-glucan levels predict adverse clinical outcomes in critical illness.JCI insight · 2021Article
- Ventilator-associated pneumonia in adults: a narrative review.Intensive care medicine · 2020Review
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe significance of Candida species in respiratory tract (RT) secretions in critically ill patients is unclear.
methodsA retrospective analysis of the Canadian ventilator-associated pneumonia (VAP) trial was conducted. Only patients with suspected VAP whose initial cultures failed to grow any known pathogens were included. Using two fundamentally different statistical techniques that adjusted for important confounding variables, the clinical outcomes of patients with Candida species recovered from RT cultures were compared with patients whose RT cultures were not positive for Candida species.
resultsRT cultures yielded no identifiable bacterial pathogens in 274 patients; 68 patients had Candida species in the RT alone, while 206 patients did not have Candida species recovered from any site. The unadjusted OR of hospital mortality for patients with Candida species was 2.9 (95% CI 1.6 to 5.2; P<0.001). The hazard ratio of time to hospital discharge was 0.54 (95% CI 0.38 to 0.77; P=0.001). Logistic regression analysis demonstrated that age, Acute Physiology score and Chronic Health Evaluation (APACHE) II score, primary diagnosis of respiratory failure, two or more comorbidities and Candida species were independently associated with increased hospital mortality. Similar trends were observed with time to hospital discharge. The association between Candida species and increased mortality remained after controlling for potential confounders using both propensity score stratification and multivariable modelling approaches.
conclusionsPatients with suspected VAP, in whom no bacterial pathogen was identified and in whom Candida species were isolated from RT cultures, exhibited a greater burden of illness compared with similar patients without Candida. Whether Candida species colonization of RT secretions is a marker of disease severity or actually contributes to poorer clinical outcomes remains unclear.
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