ArticleIntensive care medicine2019
Impact of bronchial colonization with Candida spp. on the risk of bacterial ventilator-associated pneumonia in the ICU: the FUNGIBACT prospective cohort study.
Article in Intensive care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Pooled it
- A Novel Supraglottic Suction Device in Mechanically Ventilated Patients: A Randomized Controlled Trial.Medical devices (Auckland, N.Z.) · 2025Trial
- Biomarker-guided antibiotic stewardship in suspected ventilator-associated pneumonia (VAPrapid2): a randomised controlled trial and process evaluation.The Lancet. Respiratory medicine · 2020Trial
- Stepwise model to differentiate pathogenic from non-pathogenic organisms in lower-respiratory isolates: Effectiveness and feasibility prospective cohort study.World journal of methodology · 2026Article
- No Survival Benefit Associated With Antifungal Therapy for RespiratoryOpen forum infectious diseases · 2026Article
- Co-variation between blood stream infections with Candida species versus Pseudomonas aeruginosa, Staphylococcus aureus, and other isolates among 60 ICU patient cohorts.Medical mycology · 2026Article
- Differences in Clinical Characteristics of AECOPD Patients with or withoutInternational journal of chronic obstructive pulmonary disease · 2026Article
- Oral hygiene management in critically ill patients: prevention of ventilator-associated pneumonia.Frontiers in dental medicine · 2026Review
- Associations Between Candida andMicroorganisms · 2025Article
- Graphene nanomaterials: A new frontier in preventing respiratory fungal infections.Current medical mycology · 2025Review
- Structural Equation Modelling as a Proof-of-Concept Tool for Mediation Mechanisms Between Topical Antibiotic Prophylaxis and Six Types of Blood Stream Infection Among ICU Patients.Antibiotics (Basel, Switzerland) · 2024Review
- Rebound Inverts theAntibiotics (Basel, Switzerland) · 2024Article
- Identifying the risk factors of ICU-acquired fungal infections: clinical evidence from using machine learning.Frontiers in medicine · 2024Article
- Emergence of microbial infections in some hospitals of Cairo, Egypt: studying their corresponding antimicrobial resistance profiles.BMC infectious diseases · 2023Article
- Staphylococcus aureus hitchhiking from colonization to bacteremia via Candida within ICU infection prevention studies: a proof of concept modelling.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2023Observational
- Candida and the Gram-positive trio: testing the vibe in the ICU patient microbiome using structural equation modelling of literature derived data.Emerging themes in epidemiology · 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
- Structural equation modelling the relationship between anti-fungal prophylaxis and Pseudomonas bacteremia in ICU patients.Intensive care medicine experimental · 2022Article
- Impact of Healthcare-Associated Infections Connected to Medical Devices-An Update.Microorganisms · 2021Review
Corrections and comments
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Authors and funding
9 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRespiratory tract Candida spp. colonization is associated with more frequent bacterial ventilator-associated pneumonia (VAP). However, this colonization could be causally related to VAP or simply reflect the immune paralysis associated with multiple organ failure.
objectiveTo prospectively evaluate the relationship between Candida spp. colonization and bacterial VAP in mechanically ventilated patients with multiple organ failure. INCLUSION: Patients receiving mechanical ventilation for > 4 days and presenting multiple organ failure were included. Tracheal colonization with Candida spp. was evaluated at inclusion (day 0, D0) and every 4 days until extubation. Quantitative proximal and tracheal cultures were performed at each VAP episode. Monocyte human leukocyte antigen-DR isotype (mHLA-DR) expression and the ratio of polymononuclear leukocytes to lymphocytes were used to evaluate immunoparalysis at D0 and D7. The relationship between fungal colonization and VAP was modelled using cause-specific models for repeated events with adjustment for time-dependent confounders and immune factors.
resultsA total of 213 patients, with a median age of 64, simplified acute physiology score II (SAPS II) score 55 and sequential organ failure assessment (SOFA) score 10, mainly admitted for medical reasons (n = 197, 92%), were enrolled in 2012-2015. The median ICU stay was 24 days and the mortality rate was 32% (69 cases). Median mHLA-DR was 5916 Ab-bound/cell [3863-8934]; median lymphocyte count, 0.9Giga/L [0.6-1.3]; neutrophil-to-lymphocyte ratio, 10.9 [6.5-19.7]. Overall, 146 cases (68.5%) had tracheal colonization with Candida spp. An episode of VAP occurred (either for the first or only time) in 62 (29.1%) cases 5.5 days (median) after D0; a second episode occurred in 12 (5.6%) cases, 15.5 days (median) after D0. After adjustment, bronchial colonization with Candida was not associated with VAP [adjusted cause-specific hazard ratio = 0.98 (0.59-1.65), p = 0.95].
conclusionIn patients with mechanical ventilation for more than 4 days and multiple organ failure, bronchial colonization with Candida spp. was not associated with VAP, even after adjustment for immune function.
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