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Mortality Caused by Candida auris Bloodstream Infections in Comparison with Other Candida Species, a Multicentre Retrospective Cohort

Candida auris is an emerging pathogen considered to be critical in the World Health Organization fungal organisms list. The study aims to determine the mortality and hospital stays attributed to Candida auris (C. auris) compared to other Candida species in adult patients with candidemia. A retrospec...

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Autores principales: Ortiz-Roa, Cynthia, Valderrama-Rios, Martha Carolina, Sierra-Umaña, Sebastián Felipe, Rodríguez, José Yesid, Muñetón-López, Gerardo Antonio, Solórzano-Ramos, Carlos Augusto, Escandón, Patricia, Alvarez-Moreno, Carlos Arturo, Cortés, Jorge Alberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381160/
https://www.ncbi.nlm.nih.gov/pubmed/37504704
http://dx.doi.org/10.3390/jof9070715
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author Ortiz-Roa, Cynthia
Valderrama-Rios, Martha Carolina
Sierra-Umaña, Sebastián Felipe
Rodríguez, José Yesid
Muñetón-López, Gerardo Antonio
Solórzano-Ramos, Carlos Augusto
Escandón, Patricia
Alvarez-Moreno, Carlos Arturo
Cortés, Jorge Alberto
author_facet Ortiz-Roa, Cynthia
Valderrama-Rios, Martha Carolina
Sierra-Umaña, Sebastián Felipe
Rodríguez, José Yesid
Muñetón-López, Gerardo Antonio
Solórzano-Ramos, Carlos Augusto
Escandón, Patricia
Alvarez-Moreno, Carlos Arturo
Cortés, Jorge Alberto
author_sort Ortiz-Roa, Cynthia
collection PubMed
description Candida auris is an emerging pathogen considered to be critical in the World Health Organization fungal organisms list. The study aims to determine the mortality and hospital stays attributed to Candida auris (C. auris) compared to other Candida species in adult patients with candidemia. A retrospective cohort of adults with candidemia was examined from seven centres in Colombia between 2016 and 2021. The primary outcome was 30-day mortality, and the secondary outcome was the length of hospital stay among survivors. Adjustment of the confounding variables was performed using inverse probability weights of exposure propensity score (candidemia by C. auris), survival regression models (Weibull distribution), and a counting model (negative binomial distribution). A value of 244 (47.6%) of the 512 patients with candidemia died within the first 30 days. The crude mortality in C. auris was 38.1% vs. 51.1% in Candida non-auris (CNA). In the Weibull model, mortality in the C. auris group was lower (adjusted HR: aHR- 0.69, 95% CI: 0.53–0.90). Antifungal treatment also decreased mortality, with an aHR of 0.36 (95% CI 0.27–0.47), while the presence of septic shock on patient progression increased it, with an aHR of 1.73 (95% CI 1.41–2.13). Among the patients who survived, no differences in the length of hospital stay were observed between the C. auris and the CNA groups, with an incidence rate ratio of 0.92 (95% CI: 0.68–1.22). Mortality in patients with C. auris bloodstream infections appears lower when adjusted for numerous confounding variables regarding treatment and the presence of septic shock in patient progression. We identified no significant effect of C. auris on the length of hospital stay in surviving patients.
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spelling pubmed-103811602023-07-29 Mortality Caused by Candida auris Bloodstream Infections in Comparison with Other Candida Species, a Multicentre Retrospective Cohort Ortiz-Roa, Cynthia Valderrama-Rios, Martha Carolina Sierra-Umaña, Sebastián Felipe Rodríguez, José Yesid Muñetón-López, Gerardo Antonio Solórzano-Ramos, Carlos Augusto Escandón, Patricia Alvarez-Moreno, Carlos Arturo Cortés, Jorge Alberto J Fungi (Basel) Article Candida auris is an emerging pathogen considered to be critical in the World Health Organization fungal organisms list. The study aims to determine the mortality and hospital stays attributed to Candida auris (C. auris) compared to other Candida species in adult patients with candidemia. A retrospective cohort of adults with candidemia was examined from seven centres in Colombia between 2016 and 2021. The primary outcome was 30-day mortality, and the secondary outcome was the length of hospital stay among survivors. Adjustment of the confounding variables was performed using inverse probability weights of exposure propensity score (candidemia by C. auris), survival regression models (Weibull distribution), and a counting model (negative binomial distribution). A value of 244 (47.6%) of the 512 patients with candidemia died within the first 30 days. The crude mortality in C. auris was 38.1% vs. 51.1% in Candida non-auris (CNA). In the Weibull model, mortality in the C. auris group was lower (adjusted HR: aHR- 0.69, 95% CI: 0.53–0.90). Antifungal treatment also decreased mortality, with an aHR of 0.36 (95% CI 0.27–0.47), while the presence of septic shock on patient progression increased it, with an aHR of 1.73 (95% CI 1.41–2.13). Among the patients who survived, no differences in the length of hospital stay were observed between the C. auris and the CNA groups, with an incidence rate ratio of 0.92 (95% CI: 0.68–1.22). Mortality in patients with C. auris bloodstream infections appears lower when adjusted for numerous confounding variables regarding treatment and the presence of septic shock in patient progression. We identified no significant effect of C. auris on the length of hospital stay in surviving patients. MDPI 2023-06-29 /pmc/articles/PMC10381160/ /pubmed/37504704 http://dx.doi.org/10.3390/jof9070715 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ortiz-Roa, Cynthia
Valderrama-Rios, Martha Carolina
Sierra-Umaña, Sebastián Felipe
Rodríguez, José Yesid
Muñetón-López, Gerardo Antonio
Solórzano-Ramos, Carlos Augusto
Escandón, Patricia
Alvarez-Moreno, Carlos Arturo
Cortés, Jorge Alberto
Mortality Caused by Candida auris Bloodstream Infections in Comparison with Other Candida Species, a Multicentre Retrospective Cohort
title Mortality Caused by Candida auris Bloodstream Infections in Comparison with Other Candida Species, a Multicentre Retrospective Cohort
title_full Mortality Caused by Candida auris Bloodstream Infections in Comparison with Other Candida Species, a Multicentre Retrospective Cohort
title_fullStr Mortality Caused by Candida auris Bloodstream Infections in Comparison with Other Candida Species, a Multicentre Retrospective Cohort
title_full_unstemmed Mortality Caused by Candida auris Bloodstream Infections in Comparison with Other Candida Species, a Multicentre Retrospective Cohort
title_short Mortality Caused by Candida auris Bloodstream Infections in Comparison with Other Candida Species, a Multicentre Retrospective Cohort
title_sort mortality caused by candida auris bloodstream infections in comparison with other candida species, a multicentre retrospective cohort
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381160/
https://www.ncbi.nlm.nih.gov/pubmed/37504704
http://dx.doi.org/10.3390/jof9070715
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