Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

Matteo Bassetti, Daniele R Giacobbe, Antonio Vena, Cecilia Trucchi, Filippo Ansaldi, Massimo Antonelli, Vaclava Adamkova, Cristiano Alicino, Maria-Panagiota Almyroudi, Enora Atchade, Anna M Azzini, Novella Carannante, Alessia Carnelutti, Silvia Corcione, Andrea Cortegiani, George Dimopoulos, Simon Dubler, José L García-Garmendia, Massimo Girardis, Oliver A CornelyStefano Ianniruberto, Bart Jan Kullberg, Katrien Lagrou, Clement Le Bihan, Roberto Luzzati, Manu L N G Malbrain, Maria Merelli, Ana J Marques, Ignacio Martin-Loeches, Alessio Mesini, José-Artur Paiva, Maddalena Peghin, Santi Maurizio Raineri, Riina Rautemaa-Richardson, Jeroen Schouten, Pierluigi Brugnaro, Herbert Spapen, Polychronis Tasioudis, Jean-François Timsit, Valentino Tisa, Mario Tumbarello, Charlotte H S B van den Berg, Benoit Veber, Mario Venditti, Guillaume Voiriot, Joost Wauters, Philippe Montravers

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    Abstract

    BACKGROUND: The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe.

    METHODS: A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU).

    RESULTS: During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candidemia and IAC were 5.52 and 1.84 episodes per 1000 ICU admissions, respectively. Crude 30-day mortality was 42%. Age (odds ratio [OR] 1.04 per year, 95% CI 1.02-1.06, p < 0.001), severe hepatic failure (OR 3.25, 95% 1.31-8.08, p 0.011), SOFA score at the onset of IC (OR 1.11 per point, 95% CI 1.04-1.17, p 0.001), and septic shock (OR 2.12, 95% CI 1.24-3.63, p 0.006) were associated with increased 30-day mortality in a secondary, exploratory analysis.

    CONCLUSIONS: The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions. Future in-depth analyses will allow explaining part of the observed between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions.

    Original languageEnglish
    Article number219
    Number of pages7
    JournalCritical care (London, England)
    Volume23
    Issue number1
    DOIs
    Publication statusPublished - 14-Jun-2019

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