ArticleBMC infectious diseases2017
Impact of inappropriate antifungal therapy according to current susceptibility breakpoints on Candida bloodstream infection mortality, a retrospective analysis.
Article in BMC infectious diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Candida glabrata (Nakaseomyces glabrata): A systematic review of clinical and microbiological data from 2011 to 2021 to inform the World Health Organization Fungal Priority Pathogens List.Medical mycology · 2024Pooled it
- Candida albicans-A systematic review to inform the World Health Organization Fungal Priority Pathogens List.Medical mycology · 2024Pooled it
- Comparison of clinical characteristics and outcomes in candidaemia patients with and without COVID-19: a multicentre retrospective study.BMC infectious diseases · 2024Article
- Novel evidence on sepsis-inducing pathogens: from laboratory to bedside.Frontiers in microbiology · 2023Review
- Candidemia in hospitalized cirrhotic patients with bloodstream infection: A retrospective analysis and brief summary of published studies.Journal of the Chinese Medical Association : JCMA · 2022Article
- Antifungal Resistance in Clinical Isolates ofJournal of fungi (Basel, Switzerland) · 2021Review
- No Impact of Fluconazole to Echinocandins Replacement as First-Line Therapy on the Epidemiology of Yeast Fungemia (Hospital-Driven Active Surveillance, 2004-2017, Paris, France).Frontiers in medicine · 2021Article
- A seven-year surveillance study of the epidemiology, antifungal susceptibility, risk factors and mortality of candidaemia among paediatric and adult inpatients in a tertiary teaching hospital in China.Antimicrobial resistance and infection control · 2020Observational
- Clinical Usefulness of Susceptibility Breakpoints for Yeasts in the Treatment of Candidemia: A Noninterventional Study.Journal of fungi (Basel, Switzerland) · 2020Article
- Surveillance study of the prevalence, species distribution, antifungal susceptibility, risk factors and mortality of invasive candidiasis in a tertiary teaching hospital in Southwest China.BMC infectious diseases · 2019Article
- European Committee on Antimicrobial Susceptibility Testing and Clinical and Laboratory Standards Institute breakpoints-the only point that matters in candidemia?Journal of thoracic disease · 2019Article
- Severe acute pancreatitis with blood infection by Candida glabrata complicated severe agranulocytosis: a case report.BMC infectious diseases · 2018Article
- Biomarker-guided antifungal stewardship policies for patients with invasive candidiasis.Current medical mycology · 2018Review
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10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe mortality of Candida Bloodstream Infection (CBSI) remains high. Antifungal susceptibility breakpoints were recently updated for Candida species, the impact remains unknown. In this study we evaluated the impact of inappropriate antifungal treatment according to recent breakpoints on 30-day mortality of CBSI.
methodsFrom June 2008 to July 2014, data on CBSI episodes from two tertiary-care centers, treated > 72 h were analyzed. Antifungal therapy and 30-day mortality were registered. Inappropriate antifungal treatment according to current Clinical & Laboratory Standards Institute (CLSI) breakpoints was adjusted with 30-day mortality-related co-variates.
resultsOne hundred forty-nine episodes of CBSI were analyzed. The most frequent species were: C. albicans (40%), C. tropicalis (23%) and C. glabrata complex (20%). According to the 2012 CLSI, 10.7% received inappropriate treatment. The 30-day mortality was 38%; severe sepsis [Odds ratio (OR) 3.4; 95% CI 1.3-8.4], cirrhosis (OR 36; 95% CI 12.2-605), early central venous catheter removal (OR 0.23; 95% CI 0.08-0.66) and previous antifungal therapy (OR 0.15; 95%CI 0.03-0.62), were associated with 30-day mortality by multivariate analysis. Inappropriate antifungal treatment was not (OR 0.19; 95% CI 0.03-1.2).
conclusionsAppropriate antifungal therapy according to CLSI 2012 did not have an impact on mortality. Mortality of CBSI remains high due to disease severity and comorbidities; early antifungal therapy and catheter removal may reduce it.
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