Predictors for Prolonged Hospital Stay Solely to Complete Intravenous Antifungal Treatment in Patients with Candidemia: Results from the ECMM Candida III Multinational European Observational Cohort Study - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Mycopathologia Année : 2023

Predictors for Prolonged Hospital Stay Solely to Complete Intravenous Antifungal Treatment in Patients with Candidemia: Results from the ECMM Candida III Multinational European Observational Cohort Study

Matthias Egger
Jon Salmanton-García
Aleksandra Barac
Valentina Arsic-Arsenijevic
Tadeja Matos
Rok Tomazin
  • Fonction : Auteur
Nikolai Klimko
Matteo Bassetti
Helena Hammarström
Eelco Meijer
Jacques Meis
Juergen Prattes
Robert Krause
Oguz Resat Sipahi
Ulrike Scharmann
P. Lewis White
Guillaume Desoubeaux
Julio García-Rodríguez
Carolina Garcia-Vidal
Sonia Martín-Pérez
Maite Ruiz
  • Fonction : Auteur
Mario Tumbarello
  • Fonction : Auteur
Alida Fe Talento
Benedict Rogers
Katrien Lagrou
Jens van Praet
Sevtap Arikan-Akdagli
Maiken Arendrup
Philipp Koehler
Oliver Cornely
Ana Alastruey-Izquierdo
  • Fonction : Auteur
Nick Alexander de Jonge
  • Fonction : Auteur
Tihana Bicanic
  • Fonction : Auteur
Ola Blennow
  • Fonction : Auteur
Blandine Denis
  • Fonction : Auteur
Nina Khanna
  • Fonction : Auteur
Cornelia Lass-Flörl
  • Fonction : Auteur
Clare Logan
  • Fonction : Auteur
Laura Loughlin
  • Fonction : Auteur
Volkan Özenci
  • Fonction : Auteur
Zdenek Zdenek
  • Fonction : Auteur
Laman Rahimli
  • Fonction : Auteur
Riina Rautemaa-Richardson
  • Fonction : Auteur
Joerg Steinmann
  • Fonction : Auteur
Igor Stoma
  • Fonction : Auteur
Janina Trauth
  • Fonction : Auteur
François Danion
  • Fonction : Auteur
Jochem Buil
  • Fonction : Auteur
Julio Dávila-Valls
  • Fonction : Auteur
Eric van Wijngaerden
  • Fonction : Auteur

Résumé

Abstract Background To date, azoles represent the only viable option for oral treatment of invasive Candida infections, while rates of azole resistance among non-albicans Candida spp. continue to increase. The objective of this sub-analysis of the European multicenter observational cohort study Candida III was to describe demographical and clinical characteristics of the cohort requiring prolonged hospitalization solely to complete intravenous (iv) antifungal treatment (AF Tx). Methods Each participating hospital (number of eligible hospitals per country determined by population size) included the first ~ 10 blood culture proven adult candidemia cases occurring consecutively after July 1st, 2018, and treating physicians answered the question on whether hospital stay was prolonged only for completion of intravenous antifungal therapy. Descriptive analyses as well as binary logistic regression was used to assess for predictors of prolonged hospitalization solely to complete iv AF Tx. Findings Hospital stay was prolonged solely for the completion of iv AF Tx in 16% (100/621) of candidemia cases by a median of 16 days (IQR 8 – 28). In the multivariable model, initial echinocandin treatment was a positive predictor for prolonged hospitalization to complete iv AF Tx (aOR 2.87, 95% CI 1.55 – 5.32, p < 0.001), while (i) neutropenia, (ii) intensive care unit admission, (iii) catheter related candidemia, (iv) total parenteral nutrition, and (v) C. parapsilosis as causative pathogen were found to be negative predictors (aOR 0.22 – 0.45; p < 0.03). Interpretation Hospital stays were prolonged due to need of iv AF Tx in 16% of patients with candidemia. Those patients were more likely to receive echinocandins as initial treatment and were less severely ill and less likely infected with C. parapsilosis .

Dates et versions

hal-04228702 , version 1 (04-10-2023)

Identifiants

Citer

Matthias Egger, Jon Salmanton-García, Aleksandra Barac, Jean-Pierre Gangneux, Hélène Guegan, et al.. Predictors for Prolonged Hospital Stay Solely to Complete Intravenous Antifungal Treatment in Patients with Candidemia: Results from the ECMM Candida III Multinational European Observational Cohort Study. Mycopathologia, 2023, ⟨10.1007/s11046-023-00776-4⟩. ⟨hal-04228702⟩
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