Intra-Abdominal Candidiasis in Cancer Patients: A 10-Year Experience in a Middle-Income Country

被引:0
作者
de Almeida, Bianca Leal [1 ]
Arcieri, Vitor Ciampone [2 ]
Razente, Danilo Mardegam [1 ]
Freire, Maristela Pinheiro [1 ,3 ]
Guimaraes, Thais [3 ]
de Araujo, Evangelina da Motta Pacheco Alves [4 ]
Abdala, Edson [1 ,2 ]
Magri, Marcello Mihailenko Chaves [2 ]
机构
[1] Univ Sao Paulo, Hosp Infect Control & Infect Dis Serv, Sch Med, Inst Canc Estado Sao Paulo, Sao Paulo, Brazil
[2] Univ Sao Paulo, Sch Med, Dept Infect & Parasit Dis, Sao Paulo, Brazil
[3] Univ Sao Paulo, Hosp Clin, Infect Control Dept, Sao Paulo, Brazil
[4] Fac Med USP FMUSP, Pathol Dept, Lab Microbiol Div Lab Cent, Hosp Clin, Sao Paulo, Brazil
关键词
abdominal candidiasis; cancer; <italic>Candida</italic> peritonitis; invasive candidiasis; INTENSIVE-CARE; INFECTIONS; PREVALENCE; MANAGEMENT; MORTALITY; OUTCOMES;
D O I
10.1111/myc.13807
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
BackgroundInvasive candidiasis (IC) represents a significant threat to both mortality and morbidity, especially among vulnerable populations. Intra-abdominal candidiasis (IAC) frequently occurs in critically ill and cancer patients, with these specific groups carrying a heightened risk for such invasive fungal infections. Despite this, there is a noticeable lack of attention to IAC in cancer patients within the literature, highlighting a critical gap that requires urgent consideration.ObjectivesThis study aimed to explore the clinical and epidemiological characteristics of IAC and identify prognostic factors in a cancer centre in a middle-income country over 10 years.Patients/MethodsA retrospective cohort observational study of adults diagnosed with IAC was conducted at the Instituto do Cancer do Estado de S & atilde;o Paulo (ICESP), a tertiary hospital specialising in oncological diseases with 499 beds, including 85 intensive care unit (ICU) beds, from December 2009 through May 2021.ResultsA total of 128 episodes were included: 67.2% admitted to the ICU; 54.7% males; and median age 62 years. The predominant diagnosis was peritonitis (75.8%). Blood culture samples were collected from 128 patients upon admission, revealing candidemia in 17.2% (22). The most frequently isolated were C. albicans (n = 65, 50.8%) and C. glabrata (n = 42, 32.8%). Antifungal treatment was administered to 91 (71%) patients, with fluconazole (64.8%) and echinocandins (23.4%) being the most common choices. A significant proportion of these patients had a history of abdominal surgery or antibiotic use. Independent factors associated with 30-day mortality included the median Sequential Organ Failure Assessment (SOFA) score of 6 (OR = 1.30, 95% CI 1.094-1.562, p = 0.003), days of treatment (median 10.5) (OR = 0.93, 95% CI 0.870-0.993, p = 0.031) and abdominal source control (78.1%) (OR = 0.148, 95% CI 0.030-0.719, p = 0.018). The 30-day mortality rate was 41.1%.ConclusionsOur study underscores the critical importance of implementing effective source control as a key strategy for reducing mortality in IAC.
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共 22 条
  • [1] Prognostic Trends and Current Challenges in Candidemia: A Comparative Analysis of Two Multicenter Cohorts within the Past Decade
    Agnelli, Caroline
    Guimaraes, Thais
    Sukiennik, Teresa
    Lima, Paulo Roberto Passos
    Salles, Mauro Jose
    Breda, Giovanni Luis
    Queiroz-Telles, Flavio
    Magri, Marcello Mihailenko Chaves
    Mendes, Ana Verena
    Camargo, Luis Fernando Aranha
    Morales, Hugo
    Dias, Viviane Maria de Carvalho Hessel
    Rossi, Flavia
    Colombo, Arnaldo Lopes
    [J]. JOURNAL OF FUNGI, 2023, 9 (04)
  • [2] Angarone M, 2014, CANCER TREAT RES, V161, P129, DOI 10.1007/978-3-319-04220-6_4
  • [3] Epidemiological Assessment and Risk Factors for Mortality of Bloodstream Infections by Candida sp. and the Impact of the COVID-19 Pandemic Era
    Araujo, Jordana Machado
    de Almeida Junior, Joao Nobrega
    Magri, Marcello Mihailenko Chaves
    Costa, Silvia Figueiredo
    Guimaraes, Thais
    [J]. JOURNAL OF FUNGI, 2024, 10 (04)
  • [4] Invasive Fungal Diseases in Adult Patients in Intensive Care Unit (FUNDICU): 2024 consensus definitions from ESGCIP, EFISG, ESICM, ECMM, MSGERC, ISAC, and ISHAM
    Bassetti, Matteo
    Giacobbe, Daniele R.
    Agvald-Ohman, Christina
    Akova, Murat
    Alastruey-Izquierdo, Ana
    Arikan-Akdagli, Sevtap
    Azoulay, Elie
    Blot, Stijn
    Cornely, Oliver A.
    Cuenca-Estrella, Manuel
    de Lange, Dylan W.
    De Rosa, Francesco G.
    De Waele, Jan J.
    Dimopoulos, George
    Garnacho-Montero, Jose
    Hoenigl, Martin
    Kanj, Souha S.
    Koehler, Philipp
    Kullberg, Bart J.
    Lamoth, Frederic
    Lass-Floerl, Cornelia
    Maertens, Johan
    Martin-Loeches, Ignacio
    Munoz, Patricia
    Poulakou, Garyphallia
    Rello, Jordi
    Sanguinetti, Maurizio
    Taccone, Fabio S.
    Timsit, Jean-Francois
    Torres, Antoni
    Vazquez, Jose A.
    Wauters, Joost
    Asperges, Erika
    Cortegiani, Andrea
    Grecchi, Cecilia
    Karaiskos, Ilias
    Le Bihan, Clement
    Mercier, Toine
    Mortensen, Klaus L.
    Peghin, Maddalena
    Rebuffi, Chiara
    Tejada, Sofia
    Vena, Antonio
    Zuccaro, Valentina
    Scudeller, Luigia
    Calandra, Thierry
    [J]. INTENSIVE CARE MEDICINE, 2024, 50 (04) : 502 - 515
  • [5] Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study
    Bassetti, Matteo
    Vena, Antonio
    Giacobbe, Daniele R.
    Trucchi, Cecilia
    Ansaldi, Filippo
    Antonelli, Massimo
    Adamkova, Vaclava
    Alicino, Cristiano
    Almyroudi, Maria-Panagiota
    Atchade, Enora
    Azzini, Anna M.
    Brugnaro, Pierluigi
    Carannante, Novella
    Peghin, Maddalena
    Berruti, Marco
    Carnelutti, Alessia
    Castaldo, Nadia
    Corcione, Silvia
    Cortegiani, Andrea
    Dimopoulos, George
    Dubler, Simon
    Garcia-Garmendia, Jose L.
    Girardis, Massimo
    Cornely, Oliver A.
    Ianniruberto, Stefano
    Kullberg, Bart Jan
    Lagrou, Katrien
    Lebihan, Clement
    Luzzati, Roberto
    Malbrain, Manu
    Merelli, Maria
    Marques, Ana J.
    Martin-Loeches, Ignacio
    Mesini, Alessio
    Paiva, Jose-Artur
    Raineri, Santi Maurizio
    Rautemaa-Richardson, Riina
    Schouten, Jeroen
    Spapen, Herbert
    Tasioudis, Polychronis
    Timsit, Jean-Francois
    Tisa, Valentino
    Tumbarello, Mario
    Van den Berg, Charlotte H. S. B.
    Veber, Benoit
    Venditti, Mario
    Voiriot, Guillaume
    Wauters, Joost
    Zappella, Nathalie
    Montravers, Philippe
    [J]. INFECTIOUS DISEASES AND THERAPY, 2022, 11 (02) : 827 - 840
  • [6] Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project
    Bassetti, Matteo
    Giacobbe, Daniele R.
    Vena, Antonio
    Trucchi, Cecilia
    Ansaldi, Filippo
    Antonelli, Massimo
    Adamkova, Vaclava
    Alicino, Cristiano
    Almyroudi, Maria-Panagiota
    Atchade, Enora
    Azzini, Anna M.
    Carannante, Novella
    Carnelutti, Alessia
    Corcione, Silvia
    Cortegiani, Andrea
    Dimopoulos, George
    Dubler, Simon
    Garcia-Garmendia, Jose L.
    Girardis, Massimo
    Cornely, Oliver A.
    Ianniruberto, Stefano
    Kullberg, Bart Jan
    Lagrou, Katrien
    Le Bihan, Clement
    Luzzati, Roberto
    Malbrain, Manu L. N. G.
    Merelli, Maria
    Marques, Ana J.
    Martin-Loeches, Ignacio
    Mesini, Alessio
    Paiva, Jose-Artur
    Peghin, Maddalena
    Raineri, Santi Maurizio
    Rautemaa-Richardson, Riina
    Schouten, Jeroen
    Brugnaro, Pierluigi
    Spapen, Herbert
    Tasioudis, Polychronis
    Timsit, Jean-Francois
    Tisa, Valentino
    Tumbarello, Mario
    van den Berg, Charlotte H. S. B.
    Veber, Benoit
    Venditti, Mario
    Voiriot, Guillaume
    Wauters, Joost
    Montravers, Philippe
    [J]. CRITICAL CARE, 2019, 23 (1):
  • [7] A multicenter multinational study of abdominal candidiasis: epidemiology, outcomes and predictors of mortality
    Bassetti, Matteo
    Righi, Elda
    Ansaldi, Filippo
    Merelli, Maria
    Scarparo, Claudio
    Antonelli, Massimo
    Garnacho-Montero, Jose
    Diaz-Martin, Ana
    Palacios-Garcia, Inmaculada
    Luzzati, Roberto
    Rosin, Chiara
    Lagunes, Leonel
    Rello, Jordi
    Almirante, Benito
    Scotton, Pier Giorgio
    Baldin, Gianmaria
    Dimopoulos, George
    Nucci, Marcio
    Munoz, Patricia
    Vena, Antonio
    Bouza, Emilio
    de Egea, Viviana
    Colombo, Arnaldo Lopes
    Tascini, Carlo
    Menichetti, Francesco
    Tagliaferri, Enrico
    Brugnaro, Pierluigi
    Sanguinetti, Maurizio
    Mesini, Alessio
    Sganga, Gabriele
    Viscoli, Claudio
    Tumbarello, Mario
    [J]. INTENSIVE CARE MEDICINE, 2015, 41 (09) : 1601 - 1610
  • [8] A research agenda on the management of intra-abdominal candidiasis: results from a consensus of multinational experts
    Bassetti, Matteo
    Marchetti, Monia
    Chakrabarti, Arunaloke
    Colizza, Sergio
    Garnacho-Montero, Jose
    Kett, Daniel H.
    Munoz, Patricia
    Cristini, Francesco
    Andoniadou, Anastasia
    Viale, Pierluigi
    Della Rocca, Giorgio
    Roilides, Emmanuel
    Sganga, Gabriele
    Walsh, Thomas J.
    Tascini, Carlo
    Tumbarello, Mario
    Menichetti, Francesco
    Righi, Elda
    Eckmann, Christian
    Viscoli, Claudio
    Shorr, Andrew F.
    Leroy, Olivier
    Petrikos, George
    De Rosa, Francesco Giuseppe
    [J]. INTENSIVE CARE MEDICINE, 2013, 39 (12) : 2092 - 2106
  • [9] Invasive candidiasis as a cause of sepsis in the critically ill patient
    Delaloye, Julie
    Calandra, Thierry
    [J]. VIRULENCE, 2014, 5 (01) : 161 - 169
  • [10] Predictive factors of mortality due to polymicrobial peritonitis with Candida isolation in peritoneal fluid in critically ill patients
    Dupont, H
    Paugam-Burtz, C
    Muller-Serieys, C
    Fierobe, L
    Chosidow, D
    Marmuse, JP
    Mantz, J
    Desmonts, JM
    [J]. ARCHIVES OF SURGERY, 2002, 137 (12) : 1341 - 1346