Search

Your search keyword '"Peghin, M"' showing total 14 results
Start Over Author "Peghin, M" Database OAIster
14 results on '"Peghin, M"'

1. Management of intra-abdominal infections: recommendations by the Italian council for the optimization of antimicrobial use

Author

Sartelli, M, Tascini, C, Coccolini, F, Dellai, F, Ansaloni, L, Antonelli, M, Bartoletti, M, Bassetti, M, Boncagni, F, Carlini, M, Cattelan, A, Cavaliere, A, Ceresoli, M, Cipriano, A, Cortegiani, A, Cortese, F, Cristini, F, Cucinotta, E, Dalfino, L, De Pascale, G, De Rosa, F, Falcone, M, Forfori, F, Fugazzola, P, Gatti, M, Gentile, I, Ghiadoni, L, Giannella, M, Giarratano, A, Giordano, A, Girardis, M, Mastroianni, C, Monti, G, Montori, G, Palmieri, M, Pani, M, Paolillo, C, Parini, D, Parruti, G, Pasero, D, Pea, F, Peghin, M, Petrosillo, N, Podda, M, Rizzo, C, Rossolini, G, Russo, A, Scoccia, L, Sganga, G, Signorini, L, Stefani, S, Tumbarello, M, Tumietto, F, Valentino, M, Venditti, M, Viaggi, B, Vivaldi, F, Zaghi, C, Labricciosa, F, Abu-Zidan, F, Catena, F, Viale, P, Sartelli M., Tascini C., Coccolini F., Dellai F., Ansaloni L., Antonelli M., Bartoletti M., Bassetti M., Boncagni F., Carlini M., Cattelan A. M., Cavaliere A., Ceresoli M., Cipriano A., Cortegiani A., Cortese F., Cristini F., Cucinotta E., Dalfino L., De Pascale G., De Rosa F. G., Falcone M., Forfori F., Fugazzola P., Gatti M., Gentile I., Ghiadoni L., Giannella M., Giarratano A., Giordano A., Girardis M., Mastroianni C., Monti G., Montori G., Palmieri M., Pani M., Paolillo C., Parini D., Parruti G., Pasero D., Pea F., Peghin M., Petrosillo N., Podda M., Rizzo C., Rossolini G. M., Russo A., Scoccia L., Sganga G., Signorini L., Stefani S., Tumbarello M., Tumietto F., Valentino M., Venditti M., Viaggi B., Vivaldi F., Zaghi C., Labricciosa F. M., Abu-Zidan F., Catena F., Viale P., Sartelli, M, Tascini, C, Coccolini, F, Dellai, F, Ansaloni, L, Antonelli, M, Bartoletti, M, Bassetti, M, Boncagni, F, Carlini, M, Cattelan, A, Cavaliere, A, Ceresoli, M, Cipriano, A, Cortegiani, A, Cortese, F, Cristini, F, Cucinotta, E, Dalfino, L, De Pascale, G, De Rosa, F, Falcone, M, Forfori, F, Fugazzola, P, Gatti, M, Gentile, I, Ghiadoni, L, Giannella, M, Giarratano, A, Giordano, A, Girardis, M, Mastroianni, C, Monti, G, Montori, G, Palmieri, M, Pani, M, Paolillo, C, Parini, D, Parruti, G, Pasero, D, Pea, F, Peghin, M, Petrosillo, N, Podda, M, Rizzo, C, Rossolini, G, Russo, A, Scoccia, L, Sganga, G, Signorini, L, Stefani, S, Tumbarello, M, Tumietto, F, Valentino, M, Venditti, M, Viaggi, B, Vivaldi, F, Zaghi, C, Labricciosa, F, Abu-Zidan, F, Catena, F, Viale, P, Sartelli M., Tascini C., Coccolini F., Dellai F., Ansaloni L., Antonelli M., Bartoletti M., Bassetti M., Boncagni F., Carlini M., Cattelan A. M., Cavaliere A., Ceresoli M., Cipriano A., Cortegiani A., Cortese F., Cristini F., Cucinotta E., Dalfino L., De Pascale G., De Rosa F. G., Falcone M., Forfori F., Fugazzola P., Gatti M., Gentile I., Ghiadoni L., Giannella M., Giarratano A., Giordano A., Girardis M., Mastroianni C., Monti G., Montori G., Palmieri M., Pani M., Paolillo C., Parini D., Parruti G., Pasero D., Pea F., Peghin M., Petrosillo N., Podda M., Rizzo C., Rossolini G. M., Russo A., Scoccia L., Sganga G., Signorini L., Stefani S., Tumbarello M., Tumietto F., Valentino M., Venditti M., Viaggi B., Vivaldi F., Zaghi C., Labricciosa F. M., Abu-Zidan F., Catena F., and Viale P.

Abstract

Intra-abdominal infections (IAIs) are common surgical emergencies and are an important cause of morbidity and mortality in hospital settings, particularly if poorly managed. The cornerstones of effective IAIs management include early diagnosis, adequate source control, appropriate antimicrobial therapy, and early physiologic stabilization using intravenous fluids and vasopressor agents in critically ill patients. Adequate empiric antimicrobial therapy in patients with IAIs is of paramount importance because inappropriate antimicrobial therapy is associated with poor outcomes. Optimizing antimicrobial prescriptions improves treatment effectiveness, increases patients’ safety, and minimizes the risk of opportunistic infections (such as Clostridioides difficile) and antimicrobial resistance selection. The growing emergence of multi-drug resistant organisms has caused an impending crisis with alarming implications, especially regarding Gram-negative bacteria. The Multidisciplinary and Intersociety Italian Council for the Optimization of Antimicrobial Use promoted a consensus conference on the antimicrobial management of IAIs, including emergency medicine specialists, radiologists, surgeons, intensivists, infectious disease specialists, clinical pharmacologists, hospital pharmacists, microbiologists and public health specialists. Relevant clinical questions were constructed by the Organizational Committee in order to investigate the topic. The expert panel produced recommendation statements based on the best scientific evidence from PubMed and EMBASE Library and experts’ opinions. The statements were planned and graded according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) hierarchy of evidence. On November 10, 2023, the experts met in Mestre (Italy) to debate the statements. After the approval of the statements, the expert panel met via email and virtual meetings to prepare and revise the definitive document. This document represents

Published
2024

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

Author

Bassetti, M., Vena, A., Giacobbe, D.R., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Brugnaro, P., Carannante, N., Peghin, M., Berruti, M., Carnelutti, A., Castaldo, N., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., García-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Lebihan, C., Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Van den Berg, C., Veber, B., Venditti, M., Voiriot, G., Wauters, J., Zappella, N., Montravers, P., Bassetti, M., Vena, A., Giacobbe, D.R., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Brugnaro, P., Carannante, N., Peghin, M., Berruti, M., Carnelutti, A., Castaldo, N., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., García-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Lebihan, C., Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Van den Berg, C., Veber, B., Venditti, M., Voiriot, G., Wauters, J., Zappella, N., and Montravers, P.

Abstract

Contains fulltext : 249005.pdf (Publisher’s version ) (Open Access), 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

Published
2022

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

Author

Bassetti, M., Vena, A., Giacobbe, D.R., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Brugnaro, P., Carannante, N., Peghin, M., Berruti, M., Carnelutti, A., Castaldo, N., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., García-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Lebihan, C., Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Van den Berg, C., Veber, B., Venditti, M., Voiriot, G., Wauters, J., Zappella, N., Montravers, P., Bassetti, M., Vena, A., Giacobbe, D.R., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Brugnaro, P., Carannante, N., Peghin, M., Berruti, M., Carnelutti, A., Castaldo, N., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., García-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Lebihan, C., Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Van den Berg, C., Veber, B., Venditti, M., Voiriot, G., Wauters, J., Zappella, N., and Montravers, P.

Abstract

Contains fulltext : 249005.pdf (Publisher’s version ) (Open Access), 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

Published
2022

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

Author

Bassetti, M., Vena, A., Giacobbe, D.R., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Brugnaro, P., Carannante, N., Peghin, M., Berruti, M., Carnelutti, A., Castaldo, N., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., García-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Lebihan, C., Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Van den Berg, C., Veber, B., Venditti, M., Voiriot, G., Wauters, J., Zappella, N., Montravers, P., Bassetti, M., Vena, A., Giacobbe, D.R., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Brugnaro, P., Carannante, N., Peghin, M., Berruti, M., Carnelutti, A., Castaldo, N., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., García-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Lebihan, C., Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Van den Berg, C., Veber, B., Venditti, M., Voiriot, G., Wauters, J., Zappella, N., and Montravers, P.

Abstract

Contains fulltext : 249005.pdf (Publisher’s version ) (Open Access), 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

Published
2022

5. Performance of existing definitions and tests for the diagnosis of invasive aspergillosis in critically ill, non-neutropenic, adult patients: An update including COVID-19 data

Author

Bassetti, M., Zuccaro, V., Asperges, E., Scudeller, L., Giacobbe, D. R., Akova, M., Alastruey-Izquierdo, A., Arikan-Akdagli, S., Azoulay, E., Blot, S., Cortegiani, A., Cornely, O. A., Grecchi, C., Lass-Florl, C., Koehler, P., Cuenca-Estrella, M., de Lange, D. W., De Rosa, F. G., De Waele, J. J., Dimopoulos, G., Garnacho-Montero, J., Hoenigl, M., Kanj, S. S., Lamoth, F., Maertens, J., Martin-Loeches, I., Munoz, P., Kullberg, B. J., Agvald-Ohman, C., Poulakou, G., Rebuffi, C., Rello, J., Sanguinetti, Maurizio, Taccone, F. S., Timsit, J. -F., Torres, A., Vazquez, J. A., Wauters, J., Calandra, T., Tejada, S., Karaiskos, I., Peghin, M., Vena, A., Mortensen, K. L., Lebihan, C., Mercier, T., Sanguinetti M. (ORCID:0000-0002-9780-7059), Bassetti, M., Zuccaro, V., Asperges, E., Scudeller, L., Giacobbe, D. R., Akova, M., Alastruey-Izquierdo, A., Arikan-Akdagli, S., Azoulay, E., Blot, S., Cortegiani, A., Cornely, O. A., Grecchi, C., Lass-Florl, C., Koehler, P., Cuenca-Estrella, M., de Lange, D. W., De Rosa, F. G., De Waele, J. J., Dimopoulos, G., Garnacho-Montero, J., Hoenigl, M., Kanj, S. S., Lamoth, F., Maertens, J., Martin-Loeches, I., Munoz, P., Kullberg, B. J., Agvald-Ohman, C., Poulakou, G., Rebuffi, C., Rello, J., Sanguinetti, Maurizio, Taccone, F. S., Timsit, J. -F., Torres, A., Vazquez, J. A., Wauters, J., Calandra, T., Tejada, S., Karaiskos, I., Peghin, M., Vena, A., Mortensen, K. L., Lebihan, C., Mercier, T., and Sanguinetti M. (ORCID:0000-0002-9780-7059)

Abstract

Not available

Published
2022

6. Performance of Existing Definitions and Tests for the Diagnosis of Invasive Fungal Diseases other than Invasive Candidiasis and Invasive Aspergillosis in Critically Ill, Adult Patients: A Systematic Review with Qualitative Evidence Synthesis

Author

Giacobbe, D.R., Cortegiani, A., Karaiskos, I., Mercier, T., Tejada, S., Peghin, M., Grecchi, C., Rebuffi, C., Asperges, E., Zuccaro, V., Kullberg, B.J., Scudeller, L., Bassetti, M., Giacobbe, D.R., Cortegiani, A., Karaiskos, I., Mercier, T., Tejada, S., Peghin, M., Grecchi, C., Rebuffi, C., Asperges, E., Zuccaro, V., Kullberg, B.J., Scudeller, L., and Bassetti, M.

Abstract

Contains fulltext : 245707.pdf (Publisher’s version ) (Open Access), The Fungal Infections Definitions in Intensive Care Unit (ICU) patients (FUNDICU) project aims to provide standard sets of definitions for invasive fungal diseases (IFDs) in critically ill, adult patients, including invasive aspergillosis (IA), invasive candidiasis (IC), Pneumocystis jirovecii pneumonia (PJP), and other non-IA, non-IC IFDs. The first step of the project was the conduction of separated systematic reviews of the characteristics and applicability to critically ill, adult patients outside classical populations at risk (hematology patients, solid organ transplant recipients) of available definitions and diagnostic tests for IFDs. We report here the results of two systematic reviews exploring the performance of available definitions and tests, for PJP and for other non-IA, non-IC IFDs. Starting from 2585 and 4584 records for PJP and other IFDs, respectively, 89 and 61 studies were deemed as eligible for full-text evaluation. However, only two studies for PJP and no studies for other IFDs met the FUNDICU protocol criteria for inclusion in qualitative synthesis. Currently, there is no sufficient solid data for directly evaluating the performance of existing definitions and laboratory tests for the diagnosis of PJP and other non-IA, non-IC IFDs in critically ill adult patients outside classical populations at risk.

Published
2021

7. Performance of Existing Definitions and Tests for the Diagnosis of Invasive Fungal Diseases other than Invasive Candidiasis and Invasive Aspergillosis in Critically Ill, Adult Patients: A Systematic Review with Qualitative Evidence Synthesis

Author

Giacobbe, D.R., Cortegiani, A., Karaiskos, I., Mercier, T., Tejada, S., Peghin, M., Grecchi, C., Rebuffi, C., Asperges, E., Zuccaro, V., Kullberg, B.J., Scudeller, L., Bassetti, M., Giacobbe, D.R., Cortegiani, A., Karaiskos, I., Mercier, T., Tejada, S., Peghin, M., Grecchi, C., Rebuffi, C., Asperges, E., Zuccaro, V., Kullberg, B.J., Scudeller, L., and Bassetti, M.

Abstract

Contains fulltext : 245707.pdf (Publisher’s version ) (Open Access), The Fungal Infections Definitions in Intensive Care Unit (ICU) patients (FUNDICU) project aims to provide standard sets of definitions for invasive fungal diseases (IFDs) in critically ill, adult patients, including invasive aspergillosis (IA), invasive candidiasis (IC), Pneumocystis jirovecii pneumonia (PJP), and other non-IA, non-IC IFDs. The first step of the project was the conduction of separated systematic reviews of the characteristics and applicability to critically ill, adult patients outside classical populations at risk (hematology patients, solid organ transplant recipients) of available definitions and diagnostic tests for IFDs. We report here the results of two systematic reviews exploring the performance of available definitions and tests, for PJP and for other non-IA, non-IC IFDs. Starting from 2585 and 4584 records for PJP and other IFDs, respectively, 89 and 61 studies were deemed as eligible for full-text evaluation. However, only two studies for PJP and no studies for other IFDs met the FUNDICU protocol criteria for inclusion in qualitative synthesis. Currently, there is no sufficient solid data for directly evaluating the performance of existing definitions and laboratory tests for the diagnosis of PJP and other non-IA, non-IC IFDs in critically ill adult patients outside classical populations at risk.

Published
2021

8. Ceftazidime-avibactam use for KPC-Kp infections: a retrospective observational multicenter study

Author

Tumbarello, M, Raffaelli, F, Giannella, M, Mantengoli, E, Mularoni, A, Venditti, M, De Rosa, F, Sarmati, L, Bassetti, M, Brindicci, G, Rossi, M, Luzzati, R, Grossi, P, Corona, A, Capone, A, Falcone, M, Mussini, C, Trecarichi, E, Cascio, A, Guffanti, E, Russo, A, De Pascale, G, Tascini, C, Gentile, I, Losito, A, Bussini, L, Conti, G, Ceccarelli, G, Corcione, S, Compagno, M, Giacobbe, D, Saracino, A, Fantoni, M, Antinori, S, Peghin, M, Bonfanti, P, Oliva, A, De Gasperi, A, Tiseo, G, Rovelli, C, Meschiari, M, Shbaklo, N, Spanu, T, Cauda, R, Viale, P, Tumbarello, Mario, Raffaelli, Francesca, Giannella, Maddalena, Mantengoli, Elisabetta, Mularoni, Alessandra, Venditti, Mario, De Rosa, Francesco Giuseppe, Sarmati, Loredana, Bassetti, Matteo, Brindicci, Gaetano, Rossi, Marianna, Luzzati, Roberto, Grossi, Paolo Antonio, Corona, Alberto, Capone, Alessandro, Falcone, Marco, Mussini, Cristina, Trecarichi, Enrico Maria, Cascio, Antonio, Guffanti, Elena, Russo, Alessandro, De Pascale, Gennaro, Tascini, Carlo, Gentile, Ivan, Losito, Angela Raffaella, Bussini, Linda, Conti, Giampaolo, Ceccarelli, Giancarlo, Corcione, Silvia, Compagno, Mirko, Giacobbe, Daniele Roberto, Saracino, Annalisa, Fantoni, Massimo, Antinori, Spinello, Peghin, Maddalena, Bonfanti, Paolo, Oliva, Alessandra, De Gasperi, Andrea, Tiseo, Giusy, Rovelli, Cristina, Meschiari, Marianna, Shbaklo, Nour, Spanu, Teresa, Cauda, Roberto, Viale, Pierluigi, Tumbarello, M, Raffaelli, F, Giannella, M, Mantengoli, E, Mularoni, A, Venditti, M, De Rosa, F, Sarmati, L, Bassetti, M, Brindicci, G, Rossi, M, Luzzati, R, Grossi, P, Corona, A, Capone, A, Falcone, M, Mussini, C, Trecarichi, E, Cascio, A, Guffanti, E, Russo, A, De Pascale, G, Tascini, C, Gentile, I, Losito, A, Bussini, L, Conti, G, Ceccarelli, G, Corcione, S, Compagno, M, Giacobbe, D, Saracino, A, Fantoni, M, Antinori, S, Peghin, M, Bonfanti, P, Oliva, A, De Gasperi, A, Tiseo, G, Rovelli, C, Meschiari, M, Shbaklo, N, Spanu, T, Cauda, R, Viale, P, Tumbarello, Mario, Raffaelli, Francesca, Giannella, Maddalena, Mantengoli, Elisabetta, Mularoni, Alessandra, Venditti, Mario, De Rosa, Francesco Giuseppe, Sarmati, Loredana, Bassetti, Matteo, Brindicci, Gaetano, Rossi, Marianna, Luzzati, Roberto, Grossi, Paolo Antonio, Corona, Alberto, Capone, Alessandro, Falcone, Marco, Mussini, Cristina, Trecarichi, Enrico Maria, Cascio, Antonio, Guffanti, Elena, Russo, Alessandro, De Pascale, Gennaro, Tascini, Carlo, Gentile, Ivan, Losito, Angela Raffaella, Bussini, Linda, Conti, Giampaolo, Ceccarelli, Giancarlo, Corcione, Silvia, Compagno, Mirko, Giacobbe, Daniele Roberto, Saracino, Annalisa, Fantoni, Massimo, Antinori, Spinello, Peghin, Maddalena, Bonfanti, Paolo, Oliva, Alessandra, De Gasperi, Andrea, Tiseo, Giusy, Rovelli, Cristina, Meschiari, Marianna, Shbaklo, Nour, Spanu, Teresa, Cauda, Roberto, and Viale, Pierluigi

Abstract

Background: A growing body of observational evidence supports the value of ceftazidime-avibactam (CAZ-AVI) in managing infections caused by carbapenem-resistant Enterobacteriaceae. Methods: We retrospectively analyzed observational data on use and outcomes of CAZ-AVI therapy for infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) strains. Multivariate regression analysis was used to identify variables independently associated with 30-day mortality. Results were adjusted for propensity score for receipt of CAZ-AVI combination regimens versus CAZ-AVI monotherapy. Results: The cohort comprised 577 adults with bloodstream infections (n = 391) or nonbacteremic infections involving mainly the urinary tract, lower respiratory tract, and intra-abdominal structures. All received treatment with CAZ-AVI alone (n = 165) or with ≥1 other active antimicrobials (n = 412). The all-cause mortality rate 30 days after infection onset was 25% (146/577). There was no significant difference in mortality between patients managed with CAZ-AVI alone and those treated with combination regimens (26.1% vs 25.0%, P =. 79). In multivariate analysis, mortality was positively associated with presence at infection onset of septic shock (P =. 002), neutropenia (P <. 001), or an INCREMENT score ≥8 (P =. 01); with lower respiratory tract infection (LRTI) (P =. 04); and with CAZ-AVI dose adjustment for renal function (P =. 01). Mortality was negatively associated with CAZ-AVI administration by prolonged infusion (P =. 006). All associations remained significant after propensity score adjustment. Conclusions: CAZ-AVI is an important option for treating serious KPC-Kp infections, even when used alone. Further study is needed to explore the drug's seemingly more limited efficacy in LRTIs and potential survival benefits of prolonging CAZ-AVI infusions to ≥3 hours.

Published
2021

9. A clinical predictive model of multidrug resistance in neutropenic cancer patients with bloodstream infection due to Pseudomonas aeruginosa (IRONIC study)

Author

Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, Gudiol C, Albasanz-Puig A, Laporte-Amargós J, Pallarès N, Mussetti A, Ruiz-Camps I, Puerta-Alcalde P, Abdala E, Oltolini C, Akova M, Montejo M, Mikulska M, Martín-Dávila P, Herrera F, Gasch O, Drgona L, Paz Morales H, Brunel AS, García E, Isler B, Kern WV, Morales I, Maestro-de la Calle G, Montero M, Kanj SS, Sipahi OR, Calik S, Márquez-Gómez I, Marin JI, Gomes MZR, Hemmatti P, Araos R, Peghin M, Del Pozo JL, Yáñez L, Tilley R, Manzur A, Novo A, Carratalà J, IRONIC Study Group, Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, and Gudiol C, Albasanz-Puig A, Laporte-Amargós J, Pallarès N, Mussetti A, Ruiz-Camps I, Puerta-Alcalde P, Abdala E, Oltolini C, Akova M, Montejo M, Mikulska M, Martín-Dávila P, Herrera F, Gasch O, Drgona L, Paz Morales H, Brunel AS, García E, Isler B, Kern WV, Morales I, Maestro-de la Calle G, Montero M, Kanj SS, Sipahi OR, Calik S, Márquez-Gómez I, Marin JI, Gomes MZR, Hemmatti P, Araos R, Peghin M, Del Pozo JL, Yáñez L, Tilley R, Manzur A, Novo A, Carratalà J, IRONIC Study Group

Abstract

Background: We aimed to assess the rate and predictive factors of bloodstream infection (BSI) due to multidrug-resistant (MDR) Pseudomonas aeruginosa (PA) in neutropenic cancer patients.Methods: We performed a multicenter, retrospective cohort study including onco-hematological neutropenic patients with BSI due to PA conducted across 34 centers in 12 countries from January 2006 to May 2018. A mixed logistic regression model was used to estimate a model to predict multidrug resistance of the causative pathogens.Results: Of a total of 1217 episodes of BSI due to PA, 309 episodes (25.4%) were caused by MDR strains. The rate of multidrug resistance increased significantly over the study period (p=0.033). Predictors of MDRPA BSI were prior therapy with piperacillin/tazobactam (odds ratio [OR], 3.48; 95% confidence interval [CI], 2.29-5.30), prior antipseudomonal carbapenem use (OR, 2.53; 95% CI, 1.65-3.87), fluoroquinolone prophylaxis (OR, 2.99; 95% CI, 1.92-4.64), underlying hematological disease (OR, 2.09 95% CI, 1.26-3.44) and the presence of a urinary catheter (OR, 2.54; 95% CI, 1.65-3.91), whereas older age (OR, 0.98; 95% CI, 0.97-0.99) was found to be protective.Conclusions: Our prediction model achieves good discrimination and calibration, thereby identifying neutropenic patients at higher risk of BSI due to MDRPA. The application of this model using a web-based calculator may be a simple strategy to identify high-risk patients, who may benefit from the early administration of a broad-spectrum antibiotic coverage against MDR strains according to the local susceptibility patterns, thus avoiding the use of broad-spectrum antibiotics in patients at low risk of resistance.Copyright © 2020 American Society for Microbiology.

Published
2020

10. Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

Author

Bassetti, M., Giacobbe, D.R., Vena, A., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Carannante, N., Carnelutti, A., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., Garcia-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Bihan, C. Le, Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Peghin, M., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Brugnaro, P., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Berg, C. van den, Veber, B., Venditti, M., Voiriot, G., Wauters, J., Montravers, P., Bassetti, M., Giacobbe, D.R., Vena, A., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Carannante, N., Carnelutti, A., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., Garcia-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Bihan, C. Le, Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Peghin, M., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Brugnaro, P., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Berg, C. van den, Veber, B., Venditti, M., Voiriot, G., Wauters, J., and Montravers, P.

Abstract

Contains fulltext : 206779.pdf (publisher's version ) (Open Access), BACKGROUND: The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe. METHODS: A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU). RESULTS: During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candidemia and IAC were 5.52 and 1.84 episodes per 1000 ICU admissions, respectively. Crude 30-day mortality was 42%. Age (odds ratio [OR] 1.04 per year, 95% CI 1.02-1.06, p < 0.001), severe hepatic failure (OR 3.25, 95% 1.31-8.08, p 0.011), SOFA score at the onset of IC (OR 1.11 per point, 95% CI 1.04-1.17, p 0.001), and septic shock (OR 2.12, 95% CI 1.24-3.63, p 0.006) were associated with increased 30-day mortality in a secondary, exploratory analysis. CONCLUSIONS: The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions. Future in-depth analyses will allow explaining part of the observed between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions.

Published
2019

11. Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

Author

Bassetti, M., Giacobbe, D.R., Vena, A., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Carannante, N., Carnelutti, A., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., Garcia-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Bihan, C. Le, Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Peghin, M., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Brugnaro, P., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Berg, C. van den, Veber, B., Venditti, M., Voiriot, G., Wauters, J., Montravers, P., Bassetti, M., Giacobbe, D.R., Vena, A., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Carannante, N., Carnelutti, A., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., Garcia-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Bihan, C. Le, Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Peghin, M., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Brugnaro, P., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Berg, C. van den, Veber, B., Venditti, M., Voiriot, G., Wauters, J., and Montravers, P.

Abstract

Contains fulltext : 206779.pdf (publisher's version ) (Open Access), BACKGROUND: The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe. METHODS: A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU). RESULTS: During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candidemia and IAC were 5.52 and 1.84 episodes per 1000 ICU admissions, respectively. Crude 30-day mortality was 42%. Age (odds ratio [OR] 1.04 per year, 95% CI 1.02-1.06, p < 0.001), severe hepatic failure (OR 3.25, 95% 1.31-8.08, p 0.011), SOFA score at the onset of IC (OR 1.11 per point, 95% CI 1.04-1.17, p 0.001), and septic shock (OR 2.12, 95% CI 1.24-3.63, p 0.006) were associated with increased 30-day mortality in a secondary, exploratory analysis. CONCLUSIONS: The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions. Future in-depth analyses will allow explaining part of the observed between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions.

Published
2019

12. Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

Author

Bassetti, M., Giacobbe, D.R., Vena, A., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Carannante, N., Carnelutti, A., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., Garcia-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Bihan, C. Le, Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Peghin, M., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Brugnaro, P., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Berg, C. van den, Veber, B., Venditti, M., Voiriot, G., Wauters, J., Montravers, P., Bassetti, M., Giacobbe, D.R., Vena, A., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Carannante, N., Carnelutti, A., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., Garcia-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Bihan, C. Le, Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Peghin, M., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Brugnaro, P., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Berg, C. van den, Veber, B., Venditti, M., Voiriot, G., Wauters, J., and Montravers, P.

Abstract

Contains fulltext : 206779.pdf (publisher's version ) (Open Access), BACKGROUND: The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe. METHODS: A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU). RESULTS: During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candidemia and IAC were 5.52 and 1.84 episodes per 1000 ICU admissions, respectively. Crude 30-day mortality was 42%. Age (odds ratio [OR] 1.04 per year, 95% CI 1.02-1.06, p < 0.001), severe hepatic failure (OR 3.25, 95% 1.31-8.08, p 0.011), SOFA score at the onset of IC (OR 1.11 per point, 95% CI 1.04-1.17, p 0.001), and septic shock (OR 2.12, 95% CI 1.24-3.63, p 0.006) were associated with increased 30-day mortality in a secondary, exploratory analysis. CONCLUSIONS: The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions. Future in-depth analyses will allow explaining part of the observed between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions.

Published
2019

13. Incidence and outcome of invasive candidiasis in intensive care units (icus) in europe: Results of the eucandicu project

Author

Bassetti, M., Giacobbe, D. R., Vena, A., Trucchi, C., Ansaldi, F., Antonelli, Massimo, Adamkova, V., Alicino, Monica, Almyroudi, M. -P., Atchade, E., Azzini, A. M., Carannante, N., Carnelutti, A., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., Garcia-Garmendia, J. L., Girardis, M., Cornely, O. A., Ianniruberto, S., Kullberg, B. J., Lagrou, K., Le Bihan, C., Luzzati, R., Malbrain, M. L. N. G., Merelli, M., Marques, A. J., Martin-Loeches, I., Mesini, A., Paiva, J. -A., Peghin, M., Raineri, S. M., Rautemaa-Richardson, R., Schouten, J., Brugnaro, P., Spapen, H., Tasioudis, P., Timsit, J. -F., Tisa, V., Tumbarello, Mario, Van Den Berg, C. H. S. B., Veber, B., Venditti, Mario, Voiriot, G., Wauters, J., Montravers, P., Antonelli M. (ORCID:0000-0003-3007-1670), Alicino C., Tumbarello M. (ORCID:0000-0002-9519-8552), Venditti M., Bassetti, M., Giacobbe, D. R., Vena, A., Trucchi, C., Ansaldi, F., Antonelli, Massimo, Adamkova, V., Alicino, Monica, Almyroudi, M. -P., Atchade, E., Azzini, A. M., Carannante, N., Carnelutti, A., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., Garcia-Garmendia, J. L., Girardis, M., Cornely, O. A., Ianniruberto, S., Kullberg, B. J., Lagrou, K., Le Bihan, C., Luzzati, R., Malbrain, M. L. N. G., Merelli, M., Marques, A. J., Martin-Loeches, I., Mesini, A., Paiva, J. -A., Peghin, M., Raineri, S. M., Rautemaa-Richardson, R., Schouten, J., Brugnaro, P., Spapen, H., Tasioudis, P., Timsit, J. -F., Tisa, V., Tumbarello, Mario, Van Den Berg, C. H. S. B., Veber, B., Venditti, Mario, Voiriot, G., Wauters, J., Montravers, P., Antonelli M. (ORCID:0000-0003-3007-1670), Alicino C., Tumbarello M. (ORCID:0000-0002-9519-8552), and Venditti M.

Abstract

Background: The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe. Methods: A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU). Results: During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candidemia and IAC were 5.52 and 1.84 episodes per 1000 ICU admissions, respectively. Crude 30-day mortality was 42%. Age (odds ratio [OR] 1.04 per year, 95% CI 1.02-1.06, p < 0.001), severe hepatic failure (OR 3.25, 95% 1.31-8.08, p 0.011), SOFA score at the onset of IC (OR 1.11 per point, 95% CI 1.04-1.17, p 0.001), and septic shock (OR 2.12, 95% CI 1.24-3.63, p 0.006) were associated with increased 30-day mortality in a secondary, exploratory analysis. Conclusions: The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions. Future in-depth analyses will allow explaining part of the observed between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions.

Published
2019

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

Author

Bassetti, M., Peghin, M., Carnelutti, A., Righi, E., Merelli, M., Ansaldi, F., Trucchi, C., Alicino, C., Sartor, A., Toniutto, P., Wauters, J., Laleman, W., Tascini, C., Menichetti, F., Luzzati, R., Brugnaro, P., Mesini, A., Raviolo, S., De Rosa, F. G., Lagunes, L., Rello, J., Dimopoulos, G., Colombo, A. L., Nucci, M., Vena, A., Bouza, E., Munoz, P., Tumbarello, M., Losito, R., Martin-Loeches, I., Viscoli, C., Tumbarello M. (ORCID:0000-0002-9519-8552), Bassetti, M., Peghin, M., Carnelutti, A., Righi, E., Merelli, M., Ansaldi, F., Trucchi, C., Alicino, C., Sartor, A., Toniutto, P., Wauters, J., Laleman, W., Tascini, C., Menichetti, F., Luzzati, R., Brugnaro, P., Mesini, A., Raviolo, S., De Rosa, F. G., Lagunes, L., Rello, J., Dimopoulos, G., Colombo, A. L., Nucci, M., Vena, A., Bouza, E., Munoz, P., Tumbarello, M., Losito, R., Martin-Loeches, I., Viscoli, C., and Tumbarello M. (ORCID:0000-0002-9519-8552)

Abstract

Purpose: The aim of the study was to describe the characteristics of cirrhotic patients with candidemia and intra-abdominal candidiasis (IAC) and to evaluate the risk factors associated with 30-day mortality. Methods: A multicenter multinational retrospective study including all consecutive episodes of candidemia and IAC in adult patients with liver cirrhosis in 14 European hospitals during the period 2011–2013 was performed. Results: A total of 241 episodes (169 candidemia, 72 IAC) were included. Most Candida infections were acquired in hospital (208, 86.3%), mainly in the intensive care unit (ICU) (121, 50.2%). At clinical presentation, fever was seen in 60.6% of episodes (146/241) and septic shock in 34.9% (84/241). C. albicans was the most common species (found in 131 episodes, 54.4%), followed by C. glabrata (35, 14.5%) and C. parapsilosis (34, 14.1%). Overall, the 30-day mortality was 35.3%. Multivariable analysis identified candidemia (OR 2.2, 95% CI 1.2–4.5) and septic shock (OR 3.2, 95% CI 1.7–6) as independent factors associated with 30-day mortality. Adequate antifungal treatment (OR 0.4, 95% CI 0.3–0.9) was associated with survival benefit. Conclusions: A shift towards increasing prevalence of C. glabrata and C. parapsilosis species in patients with liver disease was documented. Candidemia and IAC were associated with significant mortality in cirrhotic patients. Thirty-day mortality was associated with candidemia and severe clinical presentation, whereas adequate antifungal treatment improved the prognosis.

Published
2017

Catalog

Books, media, physical & digital resources
See catalog results