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Epidemiology of invasive fungal infections in the intensive care unit: results of a multicenter Italian survey (AURORA Project)

PURPOSE: The aims of this study are to evaluate the epidemiology of invasive fungal infections (IFIs) in patients admitted to an intensive care unit (ICU) in Southern Italy and the in vitro antifungal susceptibility of isolates. METHODS: A surveillance program was implemented in 18 ICUs. IFI cases w...

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Autores principales: Montagna, M. T., Caggiano, G., Lovero, G., De Giglio, O., Coretti, C., Cuna, T., Iatta, R., Giglio, M., Dalfino, L., Bruno, F., Puntillo, F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer-Verlag 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3671106/
https://www.ncbi.nlm.nih.gov/pubmed/23463186
http://dx.doi.org/10.1007/s15010-013-0432-0
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author Montagna, M. T.
Caggiano, G.
Lovero, G.
De Giglio, O.
Coretti, C.
Cuna, T.
Iatta, R.
Giglio, M.
Dalfino, L.
Bruno, F.
Puntillo, F.
author_facet Montagna, M. T.
Caggiano, G.
Lovero, G.
De Giglio, O.
Coretti, C.
Cuna, T.
Iatta, R.
Giglio, M.
Dalfino, L.
Bruno, F.
Puntillo, F.
author_sort Montagna, M. T.
collection PubMed
description PURPOSE: The aims of this study are to evaluate the epidemiology of invasive fungal infections (IFIs) in patients admitted to an intensive care unit (ICU) in Southern Italy and the in vitro antifungal susceptibility of isolates. METHODS: A surveillance program was implemented in 18 ICUs. IFI cases were recorded using a standardized form. RESULTS: A total of 105 episodes of IFIs occurred in 5,561 patients during the 18-month study. The main infections were caused by yeasts, more than filamentous fungi (overall incidence of 16.5 cases per 1,000 admissions and 2.3 cases per 1,000 admissions, respectively). The overall crude mortality rate was high (42.8 %), particularly for mold infections (61.5 %). All yeast infections were Candida bloodstream infections. Over half (59.8 %) were caused by Candida non-albicans, with C. parapsilosis being the most common (61.8 %). In the multivariate model, trauma admission diagnosis, prolonged stay in the ICU, and parenteral nutrition were independently associated with candidemia due to C. parapsilosis [odds ratio (OR) 3.5, (1.8–5.2); OR 3.5, (1.02–3.5); OR 3.6, (1.28–6.99), respectively]. Among mold infections, 12 patients suffered from invasive pulmonary aspergillosis, with Aspergillus fumigatus as the predominant pathogen (41.7 %). One case of brain scedosporiosis was identified. Overall, azoles and echinocandins resistance was uncommon. CONCLUSIONS: Candida non-albicans species are the most frequent cause of candidemia in ICU patients. Mold infections are associated with a high mortality rate. This study confirms the importance of the epidemiological surveillance on IFIs in the ICU setting for documenting species distribution and antimicrobial susceptibility patterns to guide therapeutic choices.
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spelling pubmed-36711062013-06-06 Epidemiology of invasive fungal infections in the intensive care unit: results of a multicenter Italian survey (AURORA Project) Montagna, M. T. Caggiano, G. Lovero, G. De Giglio, O. Coretti, C. Cuna, T. Iatta, R. Giglio, M. Dalfino, L. Bruno, F. Puntillo, F. Infection Clinical and Epidemiological Study PURPOSE: The aims of this study are to evaluate the epidemiology of invasive fungal infections (IFIs) in patients admitted to an intensive care unit (ICU) in Southern Italy and the in vitro antifungal susceptibility of isolates. METHODS: A surveillance program was implemented in 18 ICUs. IFI cases were recorded using a standardized form. RESULTS: A total of 105 episodes of IFIs occurred in 5,561 patients during the 18-month study. The main infections were caused by yeasts, more than filamentous fungi (overall incidence of 16.5 cases per 1,000 admissions and 2.3 cases per 1,000 admissions, respectively). The overall crude mortality rate was high (42.8 %), particularly for mold infections (61.5 %). All yeast infections were Candida bloodstream infections. Over half (59.8 %) were caused by Candida non-albicans, with C. parapsilosis being the most common (61.8 %). In the multivariate model, trauma admission diagnosis, prolonged stay in the ICU, and parenteral nutrition were independently associated with candidemia due to C. parapsilosis [odds ratio (OR) 3.5, (1.8–5.2); OR 3.5, (1.02–3.5); OR 3.6, (1.28–6.99), respectively]. Among mold infections, 12 patients suffered from invasive pulmonary aspergillosis, with Aspergillus fumigatus as the predominant pathogen (41.7 %). One case of brain scedosporiosis was identified. Overall, azoles and echinocandins resistance was uncommon. CONCLUSIONS: Candida non-albicans species are the most frequent cause of candidemia in ICU patients. Mold infections are associated with a high mortality rate. This study confirms the importance of the epidemiological surveillance on IFIs in the ICU setting for documenting species distribution and antimicrobial susceptibility patterns to guide therapeutic choices. Springer-Verlag 2013-03-06 2013 /pmc/articles/PMC3671106/ /pubmed/23463186 http://dx.doi.org/10.1007/s15010-013-0432-0 Text en © The Author(s) 2013 https://creativecommons.org/licenses/by/2.0/ Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Clinical and Epidemiological Study
Montagna, M. T.
Caggiano, G.
Lovero, G.
De Giglio, O.
Coretti, C.
Cuna, T.
Iatta, R.
Giglio, M.
Dalfino, L.
Bruno, F.
Puntillo, F.
Epidemiology of invasive fungal infections in the intensive care unit: results of a multicenter Italian survey (AURORA Project)
title Epidemiology of invasive fungal infections in the intensive care unit: results of a multicenter Italian survey (AURORA Project)
title_full Epidemiology of invasive fungal infections in the intensive care unit: results of a multicenter Italian survey (AURORA Project)
title_fullStr Epidemiology of invasive fungal infections in the intensive care unit: results of a multicenter Italian survey (AURORA Project)
title_full_unstemmed Epidemiology of invasive fungal infections in the intensive care unit: results of a multicenter Italian survey (AURORA Project)
title_short Epidemiology of invasive fungal infections in the intensive care unit: results of a multicenter Italian survey (AURORA Project)
title_sort epidemiology of invasive fungal infections in the intensive care unit: results of a multicenter italian survey (aurora project)
topic Clinical and Epidemiological Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3671106/
https://www.ncbi.nlm.nih.gov/pubmed/23463186
http://dx.doi.org/10.1007/s15010-013-0432-0
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