Evidence map›Paper›PMID 42365321›Full record

ArticleCritical care (London, England)2026

Decoding candidemia in critically ill patients: unsupervised clustering identifies three unique phenotypes.

Florian Reizine, Juliette Henry, Luc Desmedt, Christophe Camus, Valentin Coirier, François Arrive, Estelle Burban, Gabriel Eustache, Tony Belleville, Antoine Marc and 24 more

Abstract readMulticenter Study
In one paragraph

Article in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

What it found

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2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

34 authors.

Florian ReizineService de Réanimation Polyvalente, Vannes Hospital Center, 56000, Vannes, France. florian.reizine@gmail.com.
Juliette HenryService de Médecine Intensive-Réanimation, Bordeaux University Hospital, 33000, Bordeaux, France.
Luc DesmedtService de Médecine Intensive-Réanimation, Nantes University Hospital, 44000, Nantes, France.
Christophe CamusService de Réanimation Médicale, Rennes University Hospital, 35000, Rennes, France.
Valentin CoirierService de Réanimation Médicale, Rennes University Hospital, 35000, Rennes, France.
François ArriveService de Médecine Intensive-Réanimation, Poitiers University Hospital, 86000, Poitiers, France.
Estelle BurbanService de Médecine Intensive-Réanimation, Brest University Hospital, 29200, Brest, France.
Gabriel EustacheService de Réanimation Chirurgicale, Rennes University Hospital, 35000, Rennes, France.
Tony BellevilleService de Réanimation Chirurgicale, Brest University Hospital, 29200, Rennes, France.
Antoine MarcService de Réanimation Polyvalente, La Roche-Sur-Yon Hospital Center, 85000, La Roche-Sur-Yon, France.
Jolan MalherbeService de Médecine Intensive-Réanimation, Caen University Hospital, 14000, Caen, France.
Pierre BoujuService de Réanimation Polyvalente, Lorient Hospital Center, 56322, Lorient, France.
Paul JaubertService de Médecine Intensive-Réanimation, Angers University Hospital, 49100, Angers, France.
Olivier LesieurService de Réanimation Polyvalente, La Rochelle Hospital Center, 17019, La Rochelle, France.
Maxime LeclercService de Réanimation Polyvalente, Saint-Lô Hospital Center, 50000, Saint-Lô, France.
Pierre FillâtreService de Réanimation Polyvalente, Saint-Brieuc Hospital Center, 22000, Saint-Brieuc, France.
Aurélien FrérouService de Réanimation Polyvalente, Saint-Malo Hospital Center, 35400, Saint-Malo, France.
Renaud PrévelService de Médecine Intensive-Réanimation, Bordeaux University Hospital, 33000, Bordeaux, France.
Nolwenn MainguyService de Réanimation Polyvalente, Vannes Hospital Center, 56000, Vannes, France.
Anne CadyLaboratoire de Microbiologie, Vannes Hospital Center, 56000, Vannes, France.
Florent MorioLaboratoire de Parasitologie-Mycologie, Nantes University Hospital, 44000, Nantes, France.
Solène Le GalLaboratoire de Parasitologie-Mycologie, Brest University Hospital, 29200, Brest, France.
Estelle PerraudLaboratoire de Parasitologie-Mycologie, Poitiers University Hospital, 86000, Poitiers, France.
Laurence DelhaesLaboratoire de Parasitologie-Mycologie, Bordeaux University Hospital, 33000, Bordeaux, France.
Sébastien ImbertLaboratoire de Parasitologie-Mycologie, Bordeaux University Hospital, 33000, Bordeaux, France.
Helene GueganLaboratoire de Parasitologie-Mycologie, European ECMM Excellence Center in Medical Mycology, CHU Rennes, Centre National de Référence Pour Les Mycoses Et Antifongiques-Laboratoire Associé Aspergilloses Chroniques, Rennes, France.
Julie BonhommeLaboratoire de Parasitologie-Mycologie, Caen University Hospital, ToxEMAC-ABTE, Université de Normandie Unicaen 14000, Caen, France.
Marc PihetLaboratoire de Parasitologie-Mycologie, Angers University Hospital, 49100, Angers, France.
Clarisse DupinLaboratoire de Parasitologie-Mycologie, Saint-Brieuc Hospital, 22000, Saint Brieuc, France.
Agathe DelboveService de Réanimation Polyvalente, Vannes Hospital Center, 56000, Vannes, France.
Damien Du CheyronService de Médecine Intensive-Réanimation, Caen University Hospital, 14000, Caen, France.
Yoann LauneyService de Réanimation Chirurgicale, Rennes University Hospital, 35000, Rennes, France.
Cécile AubronService de Médecine Intensive-Réanimation, Brest University Hospital, 29200, Brest, France.
Jean-Pierre GangneuxLaboratoire de Parasitologie-Mycologie, European ECMM Excellence Center in Medical Mycology, CHU Rennes, Centre National de Référence Pour Les Mycoses Et Antifongiques-Laboratoire Associé Aspergilloses Chroniques, Rennes, France. jean-pierre.gangneux@chu-rennes.fr.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCandidemia displays significant clinical heterogeneity in critically ill patients. This study aimed to identify distinct clinical phenotypes and to assess their association with 90-day mortality.

methodsWe conducted a multicenter retrospective cohort study of 492 intensive care unit (ICU) patients with candidemia from 16 French ICUs (2015-2023). We performed a factor analysis of mixed data (FAMD) incorporating both categorical and continuous baseline variables, followed by hierarchical clustering on principal components (HCPC). Survival analysis was performed with Kaplan-Meier curves and Cox proportional hazards models.

resultsOverall, 90-day mortality for the 492 patients (median age: 64 years, 69.1% male) with candidemia was 62.6%. Three different phenotypes emerged from FAMD followed by HCPC: Phenotype 1 (n = 70, 14.2%) comprised patients with severe immunosuppression, mostly due to hematological malignancies (82.9%), and high severity scores (SAPS II:70); Phenotype 2 (n = 223, 45.3%) corresponded to elderly cirrhotic patients (19.3%) with early-onset digestive candidemia; Phenotype 3 (n = 199, 40.5%) comprised younger patients with lower severity scores and catheter-related candidemia. Mortality differed significantly between phenotypes: 72.9% (Phenotype 1), 70.4% (Phenotype 2), and 50.3% (Phenotype 3) (p < 0.001). Independent predictors of mortality included age (aHR: 1.01, 95% CI: 1.00-1.02; p = 0.003), cirrhosis (aHR: 1.90, 95% CI: 1.39-2.60; p < 0.001), SAPS II (aHR: 1.01, 95% CI: 1.01-1.02; p < 0.001), echinocandin use (aHR = 0.49, 95% CI: 0.39-0.63; p < 0.001) and proven catheter-related candidemia (protective; aHR: 0.48, 95% CI: 0.33-0.69; p < 0.001). Immunodepression was not associated with mortality.

conclusionUnsupervised clustering identified three clinically different candidemia phenotypes with different outcomes. Cirrhosis, higher age and illness severity were associated with mortality, whereas a catheter-related source of infection was protective.

Indexed as

CandidemiaPhenotypeAgedCluster AnalysisClustering AlgorithmsCohort StudiesCritical IllnessFemaleFranceHumansIntensive Care UnitsKaplan-Meier EstimateMaleMiddle AgedProportional Hazards ModelsRetrospective StudiesCandidemiaClinical phenotypesIntensive careSepsisUnsupervised clustering

Identifiers

PMID42365321
PMCPMC13573444

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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.