Usefulness of EQUAL Candida Score for predicting outcomes in patients with candidaemia: a retrospective cohort study

被引：27

作者：

Huang, Ho-Yin ^{[1
,8
]}

Lu, Po-Liang ^{[2
,3
]}

Wang, Ya-Ling ^{[1
]}

Chen, Tun-Chieh ^{[2
,5
]}

Chang, Ko ^{[2
,6
]}

Lin, Shang-Yi ^{[2
,4
,7
]}

机构：

[1] Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Pharm, Kaohsiung, Taiwan

[2] Kaohsiung Med Univ Hosp, Div Infect Dis, Dept Internal Med, Kaohsiung, Taiwan

[3] Kaohsiung Med Univ, Coll Med, Kaohsiung, Taiwan

[4] Kaohsiung Med Univ Hosp, Dept Lab Med, Kaohsiung, Taiwan

[5] Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Kaohsiung Municipal Ta Tung Hosp, Kaohsiung, Taiwan

[6] Kaohsiung Med Univ, Kaohsiung Municipal Siaogang Hosp, Dept Internal Med, Kaohsiung, Taiwan

[7] Kaohsiung Med Univ, Grad Inst Clin Med, Kaohsiung, Taiwan

[8] Kaohsiung Med Univ, Sch Pharm, Coll Pharm, Kaohsiung, Taiwan

来源：

CLINICAL MICROBIOLOGY AND INFECTION | 2020年 / 26卷 / 11期

关键词：

Antifungal treatment; Candidaemia; EQUAL Candida Score; Guideline adherence; Mortality; INFECTIOUS-DISEASES SOCIETY; ANTIFUNGAL SUSCEPTIBILITY; MANAGEMENT; GUIDELINES; DIAGNOSIS; EPIDEMIOLOGY; ENDOCARDITIS; DEFINITIONS; MORTALITY; UPDATE;

D O I：

10.1016/j.cmi.2020.01.029

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background: The European Confederation of Medical Mycology (ECMM) Quality of Clinical Candidaemia Management (EQUAL) score is a tool designed by the ECMM to measure guideline adherence. The current study investigated the association between EQUAL scores and clinical outcomes. Methods: This retrospective study was conducted in three hospitals in Taiwan. Patients with candidae-mia between January 2014 and July 2018 were enrolled. Guideline adherence was evaluated using EQUAL score indicators. Clinical outcomes and predictors of 30-day mortality were investigated. Results: A total of 384 patients were enrolled. The overall mean EQUAL score was 8.91 3.42 (9.42 +/- 3.60 in survivors vs. 8.10 +/- 2.94 in non-survivors, p < 0.001). Higher scores were positively correlated with survival (p < 0.001). Scores of 16-22 indicated the highest survival rates (p for trend 0.001). The Kaplan Meier plot revealed that patients with EQUAL scores 10. Multivariable analysis revealed that EQUAL scores 10 (odds ratio (OR) 0.37, 95% confidence interval (CI) 0.19-0.74), advanced age (OR 1.02, 95% CI 1.00-1.04), septic shock (OR 4.42, 95% CI 2.09-9.36), high sequential organ failure assessment scores (OR 4.28, 95% CI 2.15 8.52), intravascular catheter-related source (OR 0.42, 95% CI 0.19-0.94) and central venous catheter retention (OR 5.41, 95% CI 2.06-14.24) were independent predictors of 30-day mortality. Discussion: Greater guideline adherence with a higher EQUAL score was significantly associated with survival. An EQUAL score cutoff point <10 predicted 30-day mortality. (c) 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

引用

页码：1501 / 1506

页数：6

共 29 条

[1] Impact of Treatment Strategy on Outcomes in Patients with Candidemia and Other Forms of Invasive Candidiasis: A Patient-Level Quantitative Review of Randomized Trials [J].

Andes, David R. ;

Safdar, Nasia ;

Baddley, John W. ;

Playford, Geoffrey ;

Reboli, Annette C. ;

Rex, John H. ;

Sobel, Jack D. ;

Pappas, Peter G. ;

Kullberg, Bart Jan .

CLINICAL INFECTIOUS DISEASES, 2012, 54 (08) :1110-1122

[2] A multicenter study of septic shock due to candidemia: outcomes and predictors of mortality [J].

Bassetti, Matteo ;

Righi, Elda ;

Ansaldi, Filippo ;

Merelli, Maria ;

Cecilia, Trucchi ;

De Pascale, Gennaro ;

Diaz-Martin, Ana ;

Luzzati, Roberto ;

Rosin, Chiara ;

Lagunes, Leonel ;

Trecarichi, Enrico Maria ;

Sanguinetti, Maurizio ;

Posteraro, Brunella ;

Garnacho-Montero, Jose ;

Sartor, Assunta ;

Rello, Jordi ;

Della Rocca, Giorgio ;

Antonelli, Massimo ;

Tumbarello, Mario .

INTENSIVE CARE MEDICINE, 2014, 40 (06) :839-845

[3] Utility of Ophthalmologic Screening for Patients With Candida Bloodstream Infections: A Systematic Review [J].

Breazzano, Mark P. ;

Day, H. Russell, Jr. ;

Bloch, Karen C. ;

Tanaka, Sarah ;

Cherney, Edward F. ;

Sternberg, Paul, Jr. ;

Donahue, Sean P. ;

Bond, John B., III .

JAMA OPHTHALMOLOGY, 2019, 137 (06) :698-710

[4] A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].

CHARLSON, ME ;

POMPEI, P ;

ALES, KL ;

MACKENZIE, CR .

JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383

[5] Brazilian guidelines for the management of candidiasis - a joint meeting report of three medical societies: Sociedade Brasileira de Infectologia, Sociedade Paulista de Infectologia and Sociedade Brasileira de Medicina Tropical [J].

Colombo, Arnaldo Lopes y ;

Guimaraes, Thais ;

Aranha Camargo, Luis Fernando ;

Richtmann, Rosana ;

de Queiroz-Telles, Flavio ;

Costa Salles, Mauro Jose ;

da Cunha, Clovis Arns ;

Shikanai Yasuda, Maria Aparecida ;

Moretti, Maria Luiza ;

Nucci, Marcio .

BRAZILIAN JOURNAL OF INFECTIOUS DISEASES, 2013, 17 (03) :283-312

[6] ESCMID* guideline for the diagnosis and management of Candida diseases 2012: non-neutropenic adult patients [J].

Cornely, O. A. ;

Bassetti, M. ;

Calandra, T. ;

Garbino, J. ;

Kullberg, B. J. ;

Lortholary, O. ;

Meersseman, W. ;

Akova, M. ;

Arendrup, M. C. ;

Arikan-Akdagli, S. ;

Bille, J. ;

Castagnola, E. ;

Cuenca-Estrella, M. ;

Donnelly, J. P. ;

Groll, A. H. ;

Herbrecht, R. ;

Hope, W. W. ;

Jensen, H. E. ;

Lass-Floerl, C. ;

Petrikkos, G. ;

Richardson, M. D. ;

Roilides, E. ;

Verweij, P. E. ;

Viscoli, C. ;

Ullmann, A. J. .

CLINICAL MICROBIOLOGY AND INFECTION, 2012, 18 :19-37

[7] Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group [J].

De Pauw, Ben ;

Walsh, Thomas J. ;

Donnelly, J. Peter ;

Stevens, David A. ;

Edwards, John E. ;

Calandra, Thierry ;

Pappas, Peter G. ;

Maertens, Johan ;

Lortholary, Olivier ;

Kauffman, Carol A. ;

Denning, David W. ;

Patterson, Thomas F. ;

Maschmeyer, Georg ;

Bille, Jacques ;

Dismukes, William E. ;

Herbrecht, Raoul ;

Hope, William W. ;

Kibbler, Christopher C. ;

Kullberg, Bart Jan ;

Marr, Kieren A. ;

Munoz, Patricia ;

Odds, Frank C. ;

Perfect, John R. ;

Restrepo, Angela ;

Ruhnke, Markus ;

Segal, Brahm H. ;

Sobel, Jack D. ;

Sorrell, Tania C. ;

Viscoli, Claudio ;

Wingard, John R. ;

Zaoutis, Theoklis ;

Bennett, John E. .

CLINICAL INFECTIOUS DISEASES, 2008, 46 (12) :1813-1821

[8] Candidaemia in the non-neutropenic patient: A critique of the guidelines [J].

Deshpande, A. ;

Gaur, S. ;

Bal, A. M. .

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 2013, 42 (04) :294-300

[9] The search for endocarditis in patients with candidemia: a systematic recommendation for echocardiography? A prospective cohort [J].

Fernandez-Cruz, A. ;

Cruz Menarguez, M. ;

Munoz, P. ;

Pedromingo, M. ;

Pelaez, T. ;

Solis, J. ;

Rodriguez-Creixems, M. ;

Bouza, E. .

EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2015, 34 (08) :1543-1549

[10] CDC DEFINITIONS FOR NOSOCOMIAL INFECTIONS, 1988 [J].

GARNER, JS ;

JARVIS, WR ;

EMORI, TG ;

HORAN, TC ;

HUGHES, JM .

AMERICAN JOURNAL OF INFECTION CONTROL, 1988, 16 (03) :128-140

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