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Impact of Infectious Disease Consultation in Patients With Candidemia: A Retrospective Study, Systematic Literature Review, and Meta-analysis

BACKGROUND: Morbidity and mortality from candidemia remain unacceptably high. While infectious disease consultation (IDC) is known to lower the mortality from Staphylococcus aureus bacteremia, little is known about the impact of IDC in candidemia. METHODS: We conducted a retrospective observational...

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Autores principales: Kobayashi, Takaaki, Marra, Alexandre R, Schweizer, Marin L, Ten Eyck, Patrick, Wu, Chaorong, Alzunitan, Mohammed, Salinas, Jorge L, Siegel, Marc, Farmakiotis, Dimitrios, Auwaerter, Paul G, Healy, Heather S, Diekema, Daniel J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462368/
https://www.ncbi.nlm.nih.gov/pubmed/32904995
http://dx.doi.org/10.1093/ofid/ofaa270
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author Kobayashi, Takaaki
Marra, Alexandre R
Schweizer, Marin L
Ten Eyck, Patrick
Wu, Chaorong
Alzunitan, Mohammed
Salinas, Jorge L
Siegel, Marc
Farmakiotis, Dimitrios
Auwaerter, Paul G
Healy, Heather S
Diekema, Daniel J
author_facet Kobayashi, Takaaki
Marra, Alexandre R
Schweizer, Marin L
Ten Eyck, Patrick
Wu, Chaorong
Alzunitan, Mohammed
Salinas, Jorge L
Siegel, Marc
Farmakiotis, Dimitrios
Auwaerter, Paul G
Healy, Heather S
Diekema, Daniel J
author_sort Kobayashi, Takaaki
collection PubMed
description BACKGROUND: Morbidity and mortality from candidemia remain unacceptably high. While infectious disease consultation (IDC) is known to lower the mortality from Staphylococcus aureus bacteremia, little is known about the impact of IDC in candidemia. METHODS: We conducted a retrospective observational cohort study of candidemia patients at a large tertiary care hospital between 2015 and 2019. The crude mortality rate was compared between those with IDC and without IDC. Then, we systematically searched 5 databases through February 2020 and performed a meta-analysis of the impact of IDC on the mortality of patients with candidemia. RESULTS: A total of 151 patients met the inclusion criteria, 129 (85%) of whom received IDC. Thirty-day and 90-day mortality rates were significantly lower in the IDC group (18% vs 50%; P = .002; 23% vs 50%; P = .0022, respectively). A systematic literature review returned 216 reports, of which 13 studies including the present report fulfilled the inclusion criteria. Among the 13 studies with a total of 3582 patients, IDC was performed in 50% of patients. Overall mortality was 38.2% with a significant difference in favor of the IDC group (28.4% vs 47.6%), with a pooled relative risk of 0.41 (95% CI, 0.35–0.49). Ophthalmology referral, echocardiogram, and central line removal were performed more frequently among patients receiving IDC. CONCLUSIONS: This study is the first systematic literature review and meta-analysis to evaluate the association between IDC and candidemia mortality. IDC was associated with significantly lower mortality and should be considered in all patients with candidemia.
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spelling pubmed-74623682020-09-03 Impact of Infectious Disease Consultation in Patients With Candidemia: A Retrospective Study, Systematic Literature Review, and Meta-analysis Kobayashi, Takaaki Marra, Alexandre R Schweizer, Marin L Ten Eyck, Patrick Wu, Chaorong Alzunitan, Mohammed Salinas, Jorge L Siegel, Marc Farmakiotis, Dimitrios Auwaerter, Paul G Healy, Heather S Diekema, Daniel J Open Forum Infect Dis Major Articles BACKGROUND: Morbidity and mortality from candidemia remain unacceptably high. While infectious disease consultation (IDC) is known to lower the mortality from Staphylococcus aureus bacteremia, little is known about the impact of IDC in candidemia. METHODS: We conducted a retrospective observational cohort study of candidemia patients at a large tertiary care hospital between 2015 and 2019. The crude mortality rate was compared between those with IDC and without IDC. Then, we systematically searched 5 databases through February 2020 and performed a meta-analysis of the impact of IDC on the mortality of patients with candidemia. RESULTS: A total of 151 patients met the inclusion criteria, 129 (85%) of whom received IDC. Thirty-day and 90-day mortality rates were significantly lower in the IDC group (18% vs 50%; P = .002; 23% vs 50%; P = .0022, respectively). A systematic literature review returned 216 reports, of which 13 studies including the present report fulfilled the inclusion criteria. Among the 13 studies with a total of 3582 patients, IDC was performed in 50% of patients. Overall mortality was 38.2% with a significant difference in favor of the IDC group (28.4% vs 47.6%), with a pooled relative risk of 0.41 (95% CI, 0.35–0.49). Ophthalmology referral, echocardiogram, and central line removal were performed more frequently among patients receiving IDC. CONCLUSIONS: This study is the first systematic literature review and meta-analysis to evaluate the association between IDC and candidemia mortality. IDC was associated with significantly lower mortality and should be considered in all patients with candidemia. Oxford University Press 2020-08-03 /pmc/articles/PMC7462368/ /pubmed/32904995 http://dx.doi.org/10.1093/ofid/ofaa270 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Major Articles
Kobayashi, Takaaki
Marra, Alexandre R
Schweizer, Marin L
Ten Eyck, Patrick
Wu, Chaorong
Alzunitan, Mohammed
Salinas, Jorge L
Siegel, Marc
Farmakiotis, Dimitrios
Auwaerter, Paul G
Healy, Heather S
Diekema, Daniel J
Impact of Infectious Disease Consultation in Patients With Candidemia: A Retrospective Study, Systematic Literature Review, and Meta-analysis
title Impact of Infectious Disease Consultation in Patients With Candidemia: A Retrospective Study, Systematic Literature Review, and Meta-analysis
title_full Impact of Infectious Disease Consultation in Patients With Candidemia: A Retrospective Study, Systematic Literature Review, and Meta-analysis
title_fullStr Impact of Infectious Disease Consultation in Patients With Candidemia: A Retrospective Study, Systematic Literature Review, and Meta-analysis
title_full_unstemmed Impact of Infectious Disease Consultation in Patients With Candidemia: A Retrospective Study, Systematic Literature Review, and Meta-analysis
title_short Impact of Infectious Disease Consultation in Patients With Candidemia: A Retrospective Study, Systematic Literature Review, and Meta-analysis
title_sort impact of infectious disease consultation in patients with candidemia: a retrospective study, systematic literature review, and meta-analysis
topic Major Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462368/
https://www.ncbi.nlm.nih.gov/pubmed/32904995
http://dx.doi.org/10.1093/ofid/ofaa270
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