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Dynamics and Predictors of Mortality Due to Candidemia Caused by Different Candida Species: Comparison of Intensive Care Unit-Associated Candidemia (ICUAC) and Non-ICUAC
We investigated mortality and predictors of mortality due to intensive care unit-associated candidemia (ICUAC) versus non-ICUAC by Candida species. This study included all candidemia cases in 11 hospitals from 2017 to 2018 in South Korea. The all-cause mortality rates in all 370 patients with ICUAC...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397010/ https://www.ncbi.nlm.nih.gov/pubmed/34436136 http://dx.doi.org/10.3390/jof7080597 |
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author | Kwon, Yong Jun Won, Eun Jeong Jeong, Seok Hoon Shin, Kyeong Seob Shin, Jeong Hwan Kim, Young Ree Kim, Hyun Soo Kim, Young Ah Uh, Young Kim, Taek Soo Park, Jae Hyeon Lee, Jaehyeon Choi, Min Ji Byun, Seung A. Kim, Soo Hyun Shin, Jong Hee |
author_facet | Kwon, Yong Jun Won, Eun Jeong Jeong, Seok Hoon Shin, Kyeong Seob Shin, Jeong Hwan Kim, Young Ree Kim, Hyun Soo Kim, Young Ah Uh, Young Kim, Taek Soo Park, Jae Hyeon Lee, Jaehyeon Choi, Min Ji Byun, Seung A. Kim, Soo Hyun Shin, Jong Hee |
author_sort | Kwon, Yong Jun |
collection | PubMed |
description | We investigated mortality and predictors of mortality due to intensive care unit-associated candidemia (ICUAC) versus non-ICUAC by Candida species. This study included all candidemia cases in 11 hospitals from 2017 to 2018 in South Korea. The all-cause mortality rates in all 370 patients with ICUAC were approximately twofold higher than those in all 437 patients with non-ICUAC at 7 days (2.3-fold, 31.1%/13.3%), 30 days (1.9-fold, 49.5%/25.4%), and 90 days (1.9-fold, 57.8%/30.9%). Significant species-specific associations with 7- and 30-day ICUAC-associated mortality were not observed. Multivariate analysis revealed that ICU admission was an independent predictor of Candida glabrata (OR, 2.07–2.48) and Candida parapsilosis-associated mortality (OR, 6.06–11.54). Fluconazole resistance was a predictor of C. glabrata-associated mortality (OR, 2.80–5.14). Lack (less than 3 days) of antifungal therapy was the strongest predictor of 7-day mortality due to ICUAC caused by Candida albicans (OR, 18.33), Candida tropicalis (OR, 10.52), and C. glabrata (OR, 21.30) compared with 30- and 90-day mortality (OR, 2.72–6.90). C. glabrata ICUAC had a stronger association with lack of antifungal therapy (55.2%) than ICUAC caused by other species (30.6–36.7%, all p < 0.05). Most predictors of mortality associated with ICUAC were distinct from those associated with non-ICUAC and were mediated by Candida species. |
format | Online Article Text |
id | pubmed-8397010 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-83970102021-08-28 Dynamics and Predictors of Mortality Due to Candidemia Caused by Different Candida Species: Comparison of Intensive Care Unit-Associated Candidemia (ICUAC) and Non-ICUAC Kwon, Yong Jun Won, Eun Jeong Jeong, Seok Hoon Shin, Kyeong Seob Shin, Jeong Hwan Kim, Young Ree Kim, Hyun Soo Kim, Young Ah Uh, Young Kim, Taek Soo Park, Jae Hyeon Lee, Jaehyeon Choi, Min Ji Byun, Seung A. Kim, Soo Hyun Shin, Jong Hee J Fungi (Basel) Article We investigated mortality and predictors of mortality due to intensive care unit-associated candidemia (ICUAC) versus non-ICUAC by Candida species. This study included all candidemia cases in 11 hospitals from 2017 to 2018 in South Korea. The all-cause mortality rates in all 370 patients with ICUAC were approximately twofold higher than those in all 437 patients with non-ICUAC at 7 days (2.3-fold, 31.1%/13.3%), 30 days (1.9-fold, 49.5%/25.4%), and 90 days (1.9-fold, 57.8%/30.9%). Significant species-specific associations with 7- and 30-day ICUAC-associated mortality were not observed. Multivariate analysis revealed that ICU admission was an independent predictor of Candida glabrata (OR, 2.07–2.48) and Candida parapsilosis-associated mortality (OR, 6.06–11.54). Fluconazole resistance was a predictor of C. glabrata-associated mortality (OR, 2.80–5.14). Lack (less than 3 days) of antifungal therapy was the strongest predictor of 7-day mortality due to ICUAC caused by Candida albicans (OR, 18.33), Candida tropicalis (OR, 10.52), and C. glabrata (OR, 21.30) compared with 30- and 90-day mortality (OR, 2.72–6.90). C. glabrata ICUAC had a stronger association with lack of antifungal therapy (55.2%) than ICUAC caused by other species (30.6–36.7%, all p < 0.05). Most predictors of mortality associated with ICUAC were distinct from those associated with non-ICUAC and were mediated by Candida species. MDPI 2021-07-24 /pmc/articles/PMC8397010/ /pubmed/34436136 http://dx.doi.org/10.3390/jof7080597 Text en © 2021 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 Kwon, Yong Jun Won, Eun Jeong Jeong, Seok Hoon Shin, Kyeong Seob Shin, Jeong Hwan Kim, Young Ree Kim, Hyun Soo Kim, Young Ah Uh, Young Kim, Taek Soo Park, Jae Hyeon Lee, Jaehyeon Choi, Min Ji Byun, Seung A. Kim, Soo Hyun Shin, Jong Hee Dynamics and Predictors of Mortality Due to Candidemia Caused by Different Candida Species: Comparison of Intensive Care Unit-Associated Candidemia (ICUAC) and Non-ICUAC |
title | Dynamics and Predictors of Mortality Due to Candidemia Caused by Different Candida Species: Comparison of Intensive Care Unit-Associated Candidemia (ICUAC) and Non-ICUAC |
title_full | Dynamics and Predictors of Mortality Due to Candidemia Caused by Different Candida Species: Comparison of Intensive Care Unit-Associated Candidemia (ICUAC) and Non-ICUAC |
title_fullStr | Dynamics and Predictors of Mortality Due to Candidemia Caused by Different Candida Species: Comparison of Intensive Care Unit-Associated Candidemia (ICUAC) and Non-ICUAC |
title_full_unstemmed | Dynamics and Predictors of Mortality Due to Candidemia Caused by Different Candida Species: Comparison of Intensive Care Unit-Associated Candidemia (ICUAC) and Non-ICUAC |
title_short | Dynamics and Predictors of Mortality Due to Candidemia Caused by Different Candida Species: Comparison of Intensive Care Unit-Associated Candidemia (ICUAC) and Non-ICUAC |
title_sort | dynamics and predictors of mortality due to candidemia caused by different candida species: comparison of intensive care unit-associated candidemia (icuac) and non-icuac |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397010/ https://www.ncbi.nlm.nih.gov/pubmed/34436136 http://dx.doi.org/10.3390/jof7080597 |
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