Evidence map›Paper›PMID 30284179›Full record

Observational studyEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2018

The association between treatment appropriateness according to EUCAST and CLSI breakpoints and mortality among patients with candidemia: a retrospective observational study.

Nesrin Ghanem-Zoubi, Danny Zorbavel, Johad Khoury, Yuval Geffen, Majd Qasum, Svetlana Predescu, Mical Paul

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study 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 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Risk Factors for Mortality in Colombian Patients with Candidemia.Journal of fungi (Basel, Switzerland) · 2021
    Article
  5. Evaluation of Identification and Susceptibility forInternational journal of microbiology · 2021
    Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Nesrin Ghanem-ZoubiInfectious Diseases Institute, Rambam Health Care Campus, 3109601, Haifa, Israel. n_ghanem@rambam.health.gov.il.
Danny ZorbavelThe Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 3525433, Haifa, Israel.
Johad KhouryInternal Medicine Department B, Rambam Health Care Campus, 3109601, Haifa, Israel.
Yuval GeffenMicrobiology Laboratory, Rambam Health Care Campus, 3109601, Haifa, Israel.
Majd QasumInternal Medicine Department D, Rambam Health Care Campus, 3109601, Haifa, Israel.
Svetlana PredescuMicrobiology Laboratory, Rambam Health Care Campus, 3109601, Haifa, Israel.
Mical PaulInfectious Diseases Institute, Rambam Health Care Campus, 3109601, Haifa, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

To evaluate the association between appropriate antifungal treatment and mortality among patients with candidemia using different breakpoint definitions. In a retrospective study, we included all adults with candidemia in a tertiary center between 2009 and 2015. We defined three versions of appropriate (covering) antifungal treatment, according to Clinical and Laboratory Standards Institute (CLSI) 2008, CLSI 2012, and European Committee on Antimicrobial Susceptibility Testing (EUCAST) (2017 update) breakpoints. For empiric treatment, we evaluated the association with 30-day mortality. For definitive treatment, we evaluated the association with 90-day mortality among patients surviving the first week after candidemia onset. Adjusted odds ratios (OR) from a bivariate logistic regression with 95% confidence intervals are reported. We identified 302 patients with 308 separate candidemia episodes. The crude 30-day mortality was 55% (168/308). Resistance to anidulafungin increased from 3.5 to 51.6% and to fluconazole from 15.2 to 44.1%, when applying CLSI 2008 and EUCAST definitions, respectively. Appropriate empirical treatment was significantly associated with lower 30-day mortality using the CLSI 2008 definitions, adjusted OR 0.56 (0.33-0.96). The associations were similar, though not statistically significant for EUCAST, 0.58 (0.33-1.00), and CLSI 2012, OR 0.62 (0.37-1.04). Appropriate definitive treatment according to CLSI 2012 and EUCAST was independently associated with lower 90-day mortality, ORs 0.31 (0.13-0.75) and 0.44 (0.23-0.8), respectively. With CLSI 2008, the association was similar but not statistically significant, OR 0.4 (0.11-1.41), with few isolates classified as resistant. Considering the major shift in resistance prevalence when applying CLSI 2008, CLSI 2012, and EUCAST breakpoint definitions, no major differences were observed in their association with mortality.

Indexed as

AgedAntifungal AgentsCandidaCandidemiaDrug Resistance, FungalFemaleFluconazoleHumansLogistic ModelsMaleMicrobial Sensitivity TestsMiddle AgedOdds RatioRetrospective StudiesTreatment OutcomeAntifungal AgentsFluconazoleAntifungalBreakpointsCandidemiaCLSIEUCASTMortality

Identifiers

PMID30284179

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.