Evidence map›Paper›PMID 42142436›Full record

Observational studyThe Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases

Is candidemia mortality inevitable or a consequence of inadequate guideline adherence?

Murilo Freua Sequeira, Caio Trevelin Sambo, Bianca Leal de Almeida, Erika Yukie Ishigaki, Eloisa Basile Siqueira Ayub, Gabriel Fialkovitz, Adriana Satie Gonçalves Kono Magri, Olavo Henrique Munhoz Leite, Marcello Mihailenko Chaves Magri

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Murilo Freua SequeiraCentro Universitário FMABC, Disciplina de Infectologia, Santo André, SP, Brazil.
Caio Trevelin SamboUniversidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, (HCFMUSP), Divisão de Clínica de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brazil.
Bianca Leal de AlmeidaUniversidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, (HCFMUSP), Divisão de Clínica de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brazil.
Erika Yukie IshigakiCentro Universitário FMABC, Disciplina de Infectologia, Santo André, SP, Brazil.
Eloisa Basile Siqueira AyubCentro Universitário FMABC, Disciplina de Infectologia, Santo André, SP, Brazil.
Gabriel FialkovitzUniversidade de São Paulo, Hospital das Clínicas, Instituto do Coração, Departamento de Infecção Hospitalar, São Paulo, SP, Brazil.
Adriana Satie Gonçalves Kono MagriUniversidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, (HCFMUSP), Divisão de Clínica de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brazil.
Olavo Henrique Munhoz LeiteCentro Universitário FMABC, Disciplina de Infectologia, Santo André, SP, Brazil; Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, (HCFMUSP), Divisão de Clínica de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brazil.
Marcello Mihailenko Chaves MagriCentro Universitário FMABC, Disciplina de Infectologia, Santo André, SP, Brazil; Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, (HCFMUSP), Divisão de Clínica de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brazil. Electronic address: marcello.magri@hc.fm.usp.br.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCandidemia is a severe healthcare-associated infection with persistently high mortality, particularly in critically ill patients. Beyond host severity, inadequate implementation of recommended management strategies may substantially influence outcomes.

methodsThis retrospective observational study included adult patients with at least one episode of candidemia in a Brazilian tertiary hospital between 2018 and 2024. Clinical, microbiological, and therapeutic variables were analyzed, including adherence to an eight-item candidemia care bundle. In-hospital mortality was the primary outcome. Univariate, multivariate logistic regression, and Kaplan-Meier survival analyses were performed.

resultsAmong 136 patients (mean age 62.4-years), 87.5% required ICU admission. Overall mortality reached 76.5%. Candida albicans (32.4%) and the C. parapsilosis complex (29.4%) were the most frequent species. Non-optimal treatment (OR = 5.52; p = 0.031) and failure to remove the central venous catheter (OR = 6.60; p = 0.004) were independent predictors of death. Catheter removal significantly improved survival (p < 0.001). Survivors showed greater adherence to the care bundle (3.66 vs. 1.98 items; p = 0.001) and more frequent Infectious Diseases consultation (50%vs. 28.8%; p = 0.027). Mortality did not differ between catheter-drawn and peripheral blood cultures.

conclusionsIn this cohort, candidemia mortality was strongly associated with failure in early vascular source control and poor adherence to recommended management, underscoring quality of care as a key determinant of survival.

Indexed as

CandidemiaGuideline AdherenceAgedBrazilFemaleHospital MortalityHumansIntensive Care UnitsKaplan-Meier EstimateMaleMiddle AgedRetrospective StudiesRisk FactorsCandidemiaCare bundleCentral venous catheterInfectious diseases consultationSource control

Identifiers

PMID42142436
PMCPMC13212970

What OpenQuestion holds

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Registered trials

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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.