ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2018
Analyzing candidemia guideline adherence identifies opportunities for antifungal stewardship.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 42 citations in OpenAlex.
- CAMEO-a cross-sectional survey study on candidemia management in Germany.Medical mycology · 2026Article
- 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
- The 2025 EQUALJAC-antimicrobial resistance · 2025Article
- Article
- The Impact of Epidemiological Trends and Guideline Adherence on Candidemia-Associated Mortality: A 14-Year Study in Northeastern Italy.Journal of fungi (Basel, Switzerland) · 2025Article
- Molecular and biological characteristics of two rare bloodstream Candida isolates: Candida nonsorbophila and Candida sonorensis.BMC infectious diseases · 2025Article
- Evaluation of the EazyplexDiagnostics (Basel, Switzerland) · 2024Article
- Streptococcus mutans supernatant affects the virulence of Candida albicans.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2024Article
- Invasive candidiasis: current clinical challenges and unmet needs in adult populations.The Journal of antimicrobial chemotherapy · 2023Review
- Short Tandem Repeat Genotyping and Antifungal Susceptibility Testing of Latin AmericanJournal of fungi (Basel, Switzerland) · 2023Article
- EQUAL CPA Score 2022: a tool to measure guideline adherence for chronic pulmonary aspergillosis.The Journal of antimicrobial chemotherapy · 2022Article
- Analyzing Adherence to the 2016 Infectious Diseases Society of America Guidelines for Candidemia in Cancer Patients.Open forum infectious diseases · 2022Article
- EQUAL Trichosporon Score 2022: an ECMM score to measure QUALity of the clinical management of invasive Trichosporon infections.The Journal of antimicrobial chemotherapy · 2022Review
- Association between Following the ESCMID Guidelines for the Management of Candidemia and Mortality: A Retrospective Cohort Study.Journal of fungi (Basel, Switzerland) · 2022Article
- The Utility of EQUAL Candida Score in Predicting Mortality in Patients with Candidemia.Journal of fungi (Basel, Switzerland) · 2022Article
- Infection prevention requirements for the medical care of immunosuppressed patients: recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute.GMS hygiene and infection control · 2022Article
- EQUAL Score Scedosporiosis/Lomentosporiosis 2021: a European Confederation of Medical Mycology (ECMM) tool to quantify guideline adherence.The Journal of antimicrobial chemotherapy · 2021Article
- Article
- Core Recommendations for Antifungal Stewardship: A Statement of the Mycoses Study Group Education and Research Consortium.The Journal of infectious diseases · 2020Review
- Article
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Authors and funding
18 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Candidemia epidemiology varies significantly by region; thus, local data are essential for evidence-based decision-making in prophylaxis and treatment. Current management strategies are derived from large randomized controlled trials mostly executed in large high-volume tertiary care centers. Results may not be entirely transferable to smaller hospitals. This study investigates epidemiology, diagnosis, and treatment standards in six hospitals in the Cologne metropolitan area (number of inhabitants approx. one million). We assessed adherence to the current guideline of the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) and the Infectious Diseases Society of America (IDSA) using the EQUAL Candida Score of the European Confederation of Medical Mycology (ECMM). Data were documented by trained medical students as part of an integrated research and teaching concept at the University of Cologne. Between January 2014 and June 2017, 77 patients had candidemia, corresponding to an incidence of 0.2 cases/1000 admissions. While 55 patients were enrolled, 22 patients were excluded due to incompletely retrievable health records. Fluconazole monotherapy was the preferred first-line treatment in cases with Candida albicans infection (21/29). A central vascular catheter was present in 40 patients and was removed in 17 (43%) during treatment. Overall mortality at 30 days was 44%. Patients reached a mean EQUAL Candida Score of 9.9 (range 8-14), which was well below the maximum score of 22 for perfect guideline adherence. In summary, management of candidemia differed from current European recommendations. It remains unclear to what extent enhanced adherence would improve patient outcome. Larger prospective studies need to answer that question.
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