Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study

被引：24

作者：

Bassetti, Matteo ^{[1
,2
]}

Vena, Antonio ^{[1
,2
]}

Giacobbe, Daniele R. ^{[1
,2
]}

Trucchi, Cecilia ^{[3
,4
]}

Ansaldi, Filippo ^{[3
,4
]}

Antonelli, Massimo ^{[5
,6
]}

Adamkova, Vaclava ^{[7
,8
,9
]}

Alicino, Cristiano ^{[10
]}

Almyroudi, Maria-Panagiota ^{[11
]}

Atchade, Enora ^{[12
]}

Azzini, Anna M. ^{[13
]}

Brugnaro, Pierluigi ^{[14
]}

Carannante, Novella ^{[15
]}

Peghin, Maddalena ^{[16
]}

Berruti, Marco ^{[1
,2
]}

Carnelutti, Alessia ^{[16
]}

Castaldo, Nadia ^{[16
]}

Corcione, Silvia ^{[17
]}

Cortegiani, Andrea ^{[18
,53
]}

Dimopoulos, George ^{[19
]}

Dubler, Simon ^{[20
]}

Garcia-Garmendia, Jose L. ^{[21
]}

Girardis, Massimo ^{[22
]}

Cornely, Oliver A. ^{[23
,24
,55
,56
,57
]}

Ianniruberto, Stefano ^{[25
]}

Kullberg, Bart Jan ^{[26
]}

Lagrou, Katrien ^{[27
,28
,52
]}

Lebihan, Clement ^{[29
]}

Luzzati, Roberto ^{[30
]}

Malbrain, Manu ^{[31
,32
]}

Merelli, Maria ^{[16
]}

Marques, Ana J. ^{[33
]}

Martin-Loeches, Ignacio ^{[34
,35
,36
]}

Mesini, Alessio ^{[2
]}

Paiva, Jose-Artur ^{[37
]}

Raineri, Santi Maurizio ^{[18
,38
]}

Rautemaa-Richardson, Riina ^{[39
,54
]}

Schouten, Jeroen ^{[26
]}

Spapen, Herbert ^{[40
]}

Tasioudis, Polychronis ^{[41
]}

Timsit, Jean-Francois ^{[42
,43
]}

Tisa, Valentino ^{[2
]}

Tumbarello, Mario ^{[44
]}

Van den Berg, Charlotte H. S. B. ^{[45
]}

Veber, Benoit ^{[46
]}

Venditti, Mario ^{[47
]}

Voiriot, Guillaume ^{[48
]}

Wauters, Joost ^{[49
]}

Zappella, Nathalie ^{[50
]}

Montravers, Philippe ^{[51
]}

机构：

[1] Osped Policlin San Martino IRCCS, Clin Malattie Infett, Lgo R Benzi 10, I-16132 Genoa, Italy

[2] Univ Genoa, Dept Hlth Sci, Genoa, Italy

[3] ALiSa Liguria Hlth Author, Genoa, Italy

[4] Osped Policlin San Martino IRCCS, Healthcare Planning Unit, Genoa, Italy

[5] Fdn Policlin Univ Agostino Gemelli IRCCS, Dept Intens Care Anesthesiol & Emercency Med, Rome, Italy

[6] Univ Cattolica Sacro Cuore, Ist Anestesiol & Rianimaz, Milan, Italy

[7] Gen Univ Hosp, Clin Microbiol & ATB Ctr, Inst Med Biochem, Prague, Czech Republic

[8] Gen Univ Hosp, Diagnost Lab, Prague, Czech Republic

[9] Palackeho Univ, Dept Med Microbiol, Fac Med, Olomouc, Czech Republic

[10] Santa Corona Hosp, Med Direct, ASL Reg Hlth Syst Liguria 2, ASL 2 Reg Hlth Syst Liguria, Pietra Ligure, Italy

[11] Attikon Gen Univ Hosp, Athens, Greece

[12] CHU Bichat Claude, AP HP, HUPNVS, Dept Anesthesie Reanimat, Paris, France

[13] Univ Verona, Dept Diagnost & Publ Hlth, Infect Dis Unit, Verona, Italy

[14] Osped Civile SS Giovanni & Paolo, Venice, Italy

[15] Cotugno Hosp, Div Infect Dis 1, AORN Colli, Naples, Italy

[16] Santa Maria Misericordia Univ Hosp Udine, Infect Dis Clin, ASUFC, Udine, Italy

[17] Univ Turin, Dept Med Sci Infect Dis, Turin, Italy

[18] Univ Palermo, Dept Surg Onclg & Oral Sci DiChirOnS, Palermo, Italy

[19] Natl & Kapodistrian Univ Athens, Univ Hosp Attikon, Attikon Med Sch, Dept Crit Care, Athens, Greece

[20] Heidelberg Univ Hosp, Dept Anesthesiol & Intens Care Med, Heidelberg, Germany

[21] Hosp San Juan Dios Aljarafe, Serv Cuidados Crit & Urgencias, Bormujos, Seville, Spain

[22] Univ Hosp Modena, Dept Anesthesia & Intens Care, Modena, Italy

[23] Univ Cologne, Fac Med, Cologne, Germany

[24] Univ Hosp Cologne, Excellence Ctr Med Mycol ECMM, Dept Internal Med 1, Cologne, Germany

[25] Univ Bologna, S Orsola Malpighi Hosp, Infect Dis Unit, Dept Med & Surg Sci, Bologna, Italy

[26] Radboud Univ Nijmegen, Med Ctr, Radboud Umc Ctr Infect Dis, Nijmegen, Netherlands

[27] Univ Hosp Leuven, Dept Lab Med, Leuven, Belgium

[28] Univ Hosp Leuven, Natl Reference Ctr Mycosis, Leuven, Belgium

[29] Hop Xavier Bichat, AP HP, Med & Infect Dis ICU MI2, F-75018 Paris, France

[30] Azienda Sanitaria Univ Integrata Trieste, Infect Dis Dept, Trieste, Italy

[31] Univ Hosp Brussels UZB, Dept Intens Care Med, B-1090 Jette, Belgium

[32] Vrije Unversiteit Brussel VUB, Fac Med & Pharm, B-1090 Brussels, Belgium

[33] CH Vila Nova Gaia Espinho, Vila Nova De Gaia, Portugal

[34] St James Hosp, Dept Intens Care Med, Multidisciplinary Intens Care Res Org MICRO, Dublin, Ireland

[35] Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Resp, Madrid, Spain

[36] Univ Barcelona, Hosp Clin Barcelona, Inst Invest Biomed August Pi & Sunyer, Resp Inst,Pneumol Dept, Barcelona, Spain

[37] Univ Porto, Ctr Hosp Univ Sao Joao, Fac Med, Grp Infecc Sepsis,Dept Emergency & Intens Care Me, Porto, Portugal

[38] Natl Res Council CNR, Inst Biomed Res & Innovat IRIB, Palermo, Italy

[39] Univ Manchester, Div Evolut Infect & Gen, Fac Biol Med & Hlth, Manchester, England

[40] VUB Univ, Univ Ziekenhuis Brussel, Brussels, Belgium

[41] Gennimatas Gen Hosp Thessaloniki, Thessaloniki, Greece

[42] Univ Paris Diderot, Hop Bichat Reanimat Med & Malad Infectieuses, Paris, France

[43] Univ Paris Diderot, Sorbonne Paris Cite, UMR 1137-IAME Team 5 DeSCID Decision Sci Infect D, INSERM, Paris, France

[44] Univ Cattolica Sacro Cuore, Fdn Policlin Univ A Gemelli IRCCS, Inst Infect Dis, Rome, Italy

[45] Univ Med Ctr Groningen, Dept Intens Care, Groningen, Netherlands

[46] Rouen Univ Hosp, Pole Anesthesie Reanimat SAMU, Rouen, France

[47] Sapienza Univ Rome, Dept Publ Hlth & Infect Dis, Rome, Italy

[48] USC Med Chirurgicale, Hop Univ Est Parisien, Hop Tenon, AP HP,Pole TVAR,Serv Reanimat, Paris, France

[49] Univ Hosp Leuven, Dept Gen Internal Med, Med Intens Care Unit, Leuven, England

[50] Ctr Hosp Versailles, Versailles, France

来源：

INFECTIOUS DISEASES AND THERAPY | 2022年 / 11卷 / 02期

关键词：

Candida; Intra-abdominal infection; Invasive candidiasis; Risk factors; CRITICALLY III PATIENTS; CONTROLLED-TRIAL; INFECTIONS; PREDICTORS; CANDIDEMIA; EPIDEMIOLOGY; CASPOFUNGIN; MANAGEMENT; MORTALITY; CONSENSUS;

D O I：

10.1007/s40121-021-00585-6

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Introduction Intra-abdominal infections represent the second most frequently acquired infection in the intensive care unit (ICU), with mortality rates ranging from 20% to 50%. Candida spp. may be responsible for up to 10-30% of cases. This study assesses risk factors for development of intra-abdominal candidiasis (IAC) among patients admitted to ICU. Methods We performed a case-control study in 26 European ICUs during the period January 2015-December 2016. Patients at least 18 years old who developed an episode of microbiologically documented IAC during their stay in the ICU (at least 48 h after admission) served as the case cohort. The control group consisted of adult patients who did not develop episodes of IAC during ICU admission. Matching was performed at a ratio of 1:1 according to time at risk (i.e. controls had to have at least the same length of ICU stay as their matched cases prior to IAC onset), ICU ward and period of study. Results During the study period, 101 case patients with a diagnosis of IAC were included in the study. On univariate analysis, severe hepatic failure, prior receipt of antibiotics, prior receipt of parenteral nutrition, abdominal drain, prior bacterial infection, anastomotic leakage, recurrent gastrointestinal perforation, prior receipt of antifungal drugs and higher median number of abdominal surgical interventions were associated with IAC development. On multivariate analysis, recurrent gastrointestinal perforation (OR 13.90; 95% CI 2.65-72.82, p = 0.002), anastomotic leakage (OR 6.61; 95% CI 1.98-21.99, p = 0.002), abdominal drain (OR 6.58; 95% CI 1.73-25.06, p = 0.006), prior receipt of antifungal drugs (OR 4.26; 95% CI 1.04-17.46, p = 0.04) or antibiotics (OR 3.78; 95% CI 1.32-10.52, p = 0.01) were independently associated with IAC. Conclusions Gastrointestinal perforation, anastomotic leakage, abdominal drain and prior receipt of antifungals or antibiotics may help to identify critically ill patients with higher probability of developing IAC. Prospective studies are needed to identify which patients will benefit from early antifungal treatment.

引用

页码：827 / 840

页数：14

共 46 条

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共 46 条

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Kermarrec, Nathalie ;

Muller-Serieys, Claudette ;

Lasocki, Sigismond ;

Chosidow, Denis ;

Marmuse, Jean-Pierre ;

Valin, Nadia ;

Desmonts, Jean-Marie ;

Montravers, Philippe .

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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. ;

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Venditti, Mario ;

Voiriot, Guillaume ;

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Mussini, Cristina ;

Righi, Elda ;

Tascini, Carlo ;

Menichetti, Francesco ;

Mastroianni, Claudio Maria ;

Tumbarello, Mario ;

Grossi, Paolo ;

Artioli, Stefania ;

Carannante, Novella ;

Cipriani, Ludovica ;

Coletto, Davide ;

Russo, Alessandro ;

Digaetano, Margherita ;

Losito, Angela Raffaella ;

Peghin, Maddalena ;

Capone, Alessandro ;

Nicole, Stefano ;

Vena, Antonio ;

Pecori, Davide ;

Carnellutti, Alessia ;

Givone, Filippo ;

Graziano, Elena ;

Merelli, Maria ;

Cadeo, Barbara ;

Verdenelli, Stefano ;

Fabiani, Silvia ;

Gianluca, Russo ;

Oliva, Alessandra ;

Ciardi, Maria Rosa ;

Ajassa, Camilla ;

Tieghi, Tiziana ;

Tumbarello, Mario ;

Raffaelli, Francesca ;

Rovelli, Cristina ;

Caruana, Giorgia ;

Luzzati, Roberto ;

Bontempo, Giulia ;

Petrosillo, Nicola ;

Rizzardini, Giuliano ;

Coen, Massimo ;

Passerini, Matteo ;

Mastroianni, Antonio ;

Urso, Filippo ;

Bianco, Maria Francesca ;

Borgia, Guglielmo ;

Gentile, Ivan ;

Maraolo, Alberto Enrico .

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[4] Clinical characteristics and predictors of mortality in cirrhotic patients with candidemia and intra-abdominal candidiasis: a multicenter study [J].

Bassetti, Matteo ;

Peghin, Maddalena ;

Carnelutti, Alessia ;

Righi, Elda ;

Merelli, Maria ;

Ansaldi, Filippo ;

Trucchi, Cecilia ;

Alicino, Cristiano ;

Sartor, Assunta ;

Toniutto, Pierluigi ;

Wauters, Joost ;

Laleman, Wim ;

Tascini, Carlo ;

Menichetti, Francesco ;

Luzzati, Roberto ;

Brugnaro, Pierluigi ;

Mesini, Alessio ;

Raviolo, Stefania ;

De Rosa, Francesco G. ;

Lagunes, Leonel ;

Rello, Jordi ;

Dimopoulos, George ;

Colombo, Arnaldo L. ;

Nucci, Marcio ;

Vena, Antonio ;

Bouza, Emilio ;

Munoz, Patricia ;

Tumbarello, Mario ;

Losito, Raffaella ;

Martin-Loeches, Ignacio ;

Viscoli, Claudio .

INTENSIVE CARE MEDICINE, 2017, 43 (04) :509-518

[5] A multicenter multinational study of abdominal candidiasis: epidemiology, outcomes and predictors of mortality [J].

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 .

INTENSIVE CARE MEDICINE, 2015, 41 (09) :1601-1610

[6] A research agenda on the management of intra-abdominal candidiasis: results from a consensus of multinational experts [J].

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 ;

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