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01-09-2015 | Original

A multicenter multinational study of abdominal candidiasis: epidemiology, outcomes and predictors of mortality

Authors: Matteo Bassetti, Elda Righi, Filippo Ansaldi, Maria Merelli, Claudio Scarparo, Massimo Antonelli, Jose Garnacho-Montero, Ana Diaz-Martin, Inmaculada Palacios-Garcia, Roberto Luzzati, Chiara Rosin, Leonel Lagunes, Jordi Rello, Benito Almirante, Pier Giorgio Scotton, Gianmaria Baldin, George Dimopoulos, Marcio Nucci, Patricia Munoz, Antonio Vena, Emilio Bouza, Viviana de Egea, Arnaldo Lopes Colombo, Carlo Tascini, Francesco Menichetti, Enrico Tagliaferri, Pierluigi Brugnaro, Maurizio Sanguinetti, Alessio Mesini, Gabriele Sganga, Claudio Viscoli, Mario Tumbarello

Published in: Intensive Care Medicine | Issue 9/2015

Abstract

Purpose

Clinical data on patients with intra-abdominal candidiasis (IAC) is still scarce.

Methods

We collected data from 13 hospitals in Italy, Spain, Brazil, and Greece over a 3-year period (2011–2013) including patients from ICU, medical, and surgical wards.

Results

A total of 481 patients were included in the study. Of these, 27 % were hospitalized in ICU. Mean age was 63 years and 57 % of patients were male. IAC mainly consisted of secondary peritonitis (41 %) and abdominal abscesses (30 %); 68 (14 %) cases were also candidemic and 331 (69 %) had concomitant bacterial infections. The most commonly isolated Candida species were C. albicans (n = 308 isolates, 64 %) and C. glabrata (n = 76, 16 %). Antifungal treatment included echinocandins (64 %), azoles (32 %), and amphotericin B (4 %). Septic shock was documented in 40.5 % of patients. Overall 30-day hospital mortality was 27 % with 38.9 % mortality in ICU. Multivariate logistic regression showed that age (OR 1.05, 95 % CI 1.03–1.07, P < 0.001), increments in 1-point APACHE II scores (OR 1.05, 95 % CI 1.01–1.08, P = 0.028), secondary peritonitis (OR 1.72, 95 % CI 1.02–2.89, P = 0.019), septic shock (OR 3.29, 95 % CI 1.88–5.86, P < 0.001), and absence of adequate abdominal source control (OR 3.35, 95 % CI 2.01–5.63, P < 0.001) were associated with mortality. In patients with septic shock, absence of source control correlated with mortality rates above 60 % irrespective of administration of an adequate antifungal therapy.

Conclusions

Low percentages of concomitant candidemia and high mortality rates are documented in IAC. In patients presenting with septic shock, source control is fundamental.

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Title: A multicenter multinational study of abdominal candidiasis: epidemiology, outcomes and predictors of mortality
Authors: Matteo Bassetti
Elda Righi
Filippo Ansaldi
Maria Merelli
Claudio Scarparo
Massimo Antonelli
Jose Garnacho-Montero
Ana Diaz-Martin
Inmaculada Palacios-Garcia
Roberto Luzzati
Chiara Rosin
Leonel Lagunes
Jordi Rello
Benito Almirante
Pier Giorgio Scotton
Gianmaria Baldin
George Dimopoulos
Marcio Nucci
Patricia Munoz
Antonio Vena
Emilio Bouza
Viviana de Egea
Arnaldo Lopes Colombo
Carlo Tascini
Francesco Menichetti
Enrico Tagliaferri
Pierluigi Brugnaro
Maurizio Sanguinetti
Alessio Mesini
Gabriele Sganga
Claudio Viscoli
Mario Tumbarello
Publication date: 01-09-2015
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 9/2015
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-015-3866-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A multicenter multinational study of abdominal candidiasis: epidemiology, outcomes and predictors of mortality

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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