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Zusammenfassung Hintergrund Die aktuelle COVID-19-Pandemie stellt, trotz der Verfügbarkeit von Schnelltests und des Starts der Impfkampagne, die Notaufnahme weiterhin vor große Herausforderungen. Die strukturierte Erfassung von demographischen, klinischen sowie therapiebezogenen Daten stellt die Grundlage für die Erstellung evidenzbasierter Prozesse und Behandlungskonzepte dar. Ziel der Arbeit Darstellung der systematischen Erfassung klinischer Parameter bei Patienten mit COVID-19-Verdacht im Notaufnahmeregister ReCovER (Registry for COVID-19 in the Emergency Room) sowie deskriptive Darstellung der ersten 1000 Patienten. Material und Methoden In zentralen Notaufnahmen (ZNA) von 6 Universitätskliniken werden kontinuierlich Daten von Patienten mit COVID-19-Verdacht, unabhängig vom Nachweis einer SARS-CoV-2-Infektion, in ein webbasiertes, anonymisiertes Register eingegeben. Ergebnisse Zwischen dem 19.05.2020 und dem 13.01.2021 wurden 1000 Patienten in das Register eingegeben, hiervon waren 594 Patienten (59,4 %) in der SARS-CoV-2-positiven (PG) und 406 Patienten (40,6 %) in der negativen Gruppe (NG). Patienten der PG hatten signifikant weniger Vorerkrankungen und eine deutlich längere Latenz zwischen Symptombeginn und Vorstellung in der ZNA (Median 5 vs. 3 Tage), litten häufiger unter Husten, Myalgien, Fatigue sowie Geruchs/Geschmacksverlust und hatten einen signifikant höheren Sauerstoffbedarf als die NG-Patienten. Die Rate von schweren Krankheitsverläufen war in der PG signifikant erhöht und es bestanden nach Entlassung häufiger persistierende Symptome (11,1 vs. 4,6 %). Schlussfolgerungen Durch die multizentrische Erfassung von umfangreichen klinischen Daten zu COVID-19-Verdachtsfällen in der Notaufnahme können insbesondere auch für die Situation in Deutschland spezifische Aspekte analysiert werden. Dies ist essenziell für eine gezielte Überprüfung und Adaption international publizierter Strategien.

Caloric restriction (CR)-mediated organ protection has been shown to be extremely efficient in rodent models of acute kidney injury (AKI). Limited understanding of the underlying mechanisms paired with a risk of malnourishment and feasibility problems has hindered the translation of this immense potential to the patient setting. In this mini-review, the current mechanistic concepts of CR-mediated stress-resistance as potential key targets for renal protection in AKI will be highlighted.

Background Frequent outbreaks around the globe and endemic appearance in different parts of the world emphasize the substantial risk of hantavirus diseases. Increasing incidence rates, trends of changing distribution of hantavirus species and new insights into clinical courses of hantavirus diseases call for multinational surveillance. Furthermore, evidence-based guidelines for the management of hantavirus diseases and scoring systems, which allow stratification of patients into risk categories, are lacking. Methods Hantavirus registry (HantaReg) is a novel registry platform facilitating multinational research of hantavirus-caused diseases, such as haemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS). HantaReg provides an electronic case report form and uses the General Data Protection Regulation compliant platform clinicalsurveys.net, which can be accessed from any internet browser in the world. Having a modular structure, the registry platform is designed to display or hide questions and items according to the documented case (e.g. patient with HFRS versus HCPS) to facilitate fast, but standardized, data entry. Information categories documented in HantaReg are demographics, pre-existing diseases, clinical presentation, diagnostic and therapeutic approaches, as well as outcome. Conclusions HantaReg is a novel, ready-to-use platform for clinical and epidemiological studies on hantavirus diseases and facilitates the documentation of the disease course associated with hantavirus infections. HantaReg is expected to promote international collaboration and contributes to improving patient care through the analysis of diagnostic and treatment pathways for hantavirus diseases, providing evidence for robust treatment recommendations. Moreover, HantaReg enables the development of prognosis-indicating scoring systems for patients with hantavirus disease.

OBJECTIVES Candidemia is among the most frequent nosocomial bloodstream infections. Landmark case-control studies on amphotericin B and fluconazole estimated attributable mortality rates of 38% and 49%, respectively. After introduction of echinocandins, these may have decreased. METHODS In a case-control design, 100 consecutive, hospitalised patients with candidemia were enrolled at the University Hospital of Cologne, Germany between 2014 and 2017. Controls were patients without candidemia matched for age, sex, year and duration of hospitalisation, main admission diagnosis and Patient Clinical Complexity Level (PCCL). Main data captured were risk factors for candidemia, attributable mortality rates and diagnostic and therapeutic adherence according to the EQUAL Candida score. RESULTS Overall mortality rates for cases and controls were 43% and 17% (P

Caloric Restriction (CR) extends lifespan and augments cellular stress-resistance from yeast to primates, making CR an attractive strategy for organ protection in the clinic. Translation of CR to patients is complex, due to problems regarding adherence, feasibility and safety concerns in frail patients. Novel tailored dietary regimens, which modulate the dietary composition of macro- and micronutrients rather than reducing calorie intake promise similar protective effects and increased translatability. However, a direct head-to-head comparison to identify the most potent approach for organ protection as well as overlapping metabolic consequences has not been performed. We systematically analyzed six dietary preconditioning protocols - fasting mimicking diet (FMD), ketogenic diet (KD), dietary restriction of branched chained amino acids (BCAA), two dietary regimens restricting sulfur-containing amino acids (SR80/100) and CR - in a rodent model of renal ischemia-reperfusion injury (IRI) to quantify diet-induced resilience in kidneys. Of the administered diets, FMD, SR80/100 and CR efficiently protect from kidney damage after IRI. Interestingly, these approaches show overlapping changes in oxidative and hydrogen sulfide (H2S)-dependent cysteine catabolism as a potential common mechanism of organ protection.

Caloric Restriction (CR) extends lifespan and augments cellular stress-resistance from yeast to primates, making CR an attractive strategy for organ protection in the clinic. Translation of CR to patients is complex, due to problems regarding adherence, feasibility and safety concerns in frail patients. Novel tailored dietary regimens, which modulate the dietary composition of macro- and micronutrients rather than reducing calorie intake promise similar protective effects and increased translatability. However, a direct head-to-head comparison to identify the most potent approach for organ protection as well as overlapping metabolic consequences has not been performed. We systematically analyzed six dietary preconditioning protocols - fasting mimicking diet (FMD), ketogenic diet (KD), dietary restriction of branched chained amino acids (BCAA), two dietary regimens restricting sulfur-containing amino acids (SR80/100) and CR - in a rodent model of renal ischemia-reperfusion injury (IRI) to quantify diet-induced resilience in kidneys. Of the administered diets, FMD, SR80/100 and CR efficiently protect from kidney damage after IRI. Interestingly, these approaches show overlapping changes in oxidative and hydrogen sulfide (H2S)-dependent cysteine catabolism as a potential common mechanism of organ protection. Importantly, these metabolic changes can be recapitulated in patients preconditioned by a diet limiting sulfur-containing amino acids indicating conserved diet-induced mechanisms of stress-resistance that may ultimately lead to clinical application.

BACKGROUND: Diseases of the glomeruli, the renal filtration units, are a leading cause of progressive kidney disease. Assessment of the ultrastructure of podocytes at the glomerular filtration barrier is essential for diagnosing diverse disease entities, providing insight into the disease pathogenesis, and monitoring treatment responses. METHODS: Here we apply previously published sample preparation methods together with stimulated emission depletion and confocal microscopy for resolving nanoscale podocyte substructure. The protocols are modified and optimized in order to be applied to formalin-fixed paraffin-embedded (FFPE) samples. RESULTS: We successfully modified our protocols to allow for deep three-dimensional stimulated emission depletion and confocal imaging of FFPE kidney tissue with similar staining and image quality compared with our previous approaches. We further show that quantitative analysis can be applied to extract morphometrics from healthy and diseased samples from both mice and humans. CONCLUSIONS: The results from this study could increase the feasibility of implementing optical kidney imaging protocols in clinical routines because FFPE is the gold-standard method for storage of patient samples.

Acute kidney injury (AKI) is a frequent and critical complication in the clinical setting. In rodents AKI can be prevented effectively through caloric restriction (CR), which has also been shown to increase lifespan in many species. In Caenorhabditis elegans (C. elegans) longevity studies revealed that a marked CR-induced reduction of endocannabinoids may be a key mechanism. Thus, we hypothesized that regulation of endocannabinoids, in particular arachidonoyl ethanolamide (AEA), might also play a role in CR-mediated protection from renal ischemia-reperfusion injury (IRI) in mammals including humans. In male C57Bl6J mice, CR significantly reduced renal IRI and led to a significant decrease of AEA. Supplementation of AEA to near-normal serum concentrations by repetitive intraperitoneal administration in CR mice, however, did not abrogate the protective effect of CR. We also analyzed serum samples taken before and after CR from patients of three different pilot trials of dietary interventions. In contrast to mice and C. elegans, we detected an increase of AEA. We conclude that endocannabinoid levels in mice are modulated by CR, but CR-mediated renal protection does not depend on this effect. Moreover, our results indicate that modulation of endocannabinoids by CR in humans may differ fundamentally from the effects in animal models.

Diseases of the renal filtration unit—the glomerulus—are the most common cause of chronic kidney disease. Podocytes are the pivotal cell type for the function of this filter and focal-segmental glomerulosclerosis (FSGS) is a classic example of a podocytopathy leading to proteinuria and glomerular scarring. Currently, no targeted treatment of FSGS is available. This lack of therapeutic strategies is explained by a limited understanding of the defects in podocyte cell biology leading to FSGS. To date, most studies in the field have focused on protein-coding genes and their gene products. However, more than 80% of all transcripts produced by mammalian cells are actually non-coding. Here, long non-coding RNAs (lncRNAs) are a relatively novel class of transcripts and have not been systematically studied in FSGS to date. The appropriate tools to facilitate lncRNA research for the renal scientific community are urgently required due to a row of challenges compared to classical analysis pipelines optimized for coding RNA expression analysis. Here, we present the bioinformatic pipeline CALINCA as a solution for this problem. CALINCA automatically analyzes datasets from murine FSGS models and quantifies both annotated and de novo assembled lncRNAs. In addition, the tool provides in-depth information on podocyte specificity of these lncRNAs, as well as evolutionary conservation and expression in human datasets making this pipeline a crucial basis to lncRNA studies in FSGS.

The current COVID-19 pandemic, despite the availability of rapid tests and the start of the vaccination campaign, continues to pose major challenges to emergency departments (ED). Structured collection of demographic, clinical, as well as treatment-related data provides the basis for establishing evidence-based processes and treatment concepts.To present the systematic collection of clinical parameters in patients with suspected COVID-19 in the Registry for COVID-19 in the Emergency Room (ReCovER) and descriptive presentation of the first 1000 patients.Data from patients with suspected COVID-19, regardless of evidence of SARS-CoV‑2 infection, are continuously entered into a web-based, anonymized registry in ED at six university hospitals.Between 19 May 2020 and 13 January 2021, 1000 patients were entered into the registry, of whom 594 patients (59.4%) were in the SARS-CoV‑2 positive group (PG) and 406 patients (40.6%) were in the negative group (NG). Patients of the PG had significantly fewer pre-existing conditions and a significantly longer latency between symptom onset and presentation to the ED (median 5 vs. 3 days), were more likely to suffer from cough, myalgia, fatigue, and loss of smell/taste and had significantly higher oxygen requirements than NG patients. The rate of severe disease progression was significantly higher in the PG, and persistent symptoms were more common after discharge (11.1 vs. 4.6%).The multicenter collection of comprehensive clinical data on COVID-19 suspected cases in the ED allows analysis of aspects specific to the situation in Germany in particular. This is essential for a targeted review and adaptation of internationally published strategies.HINTERGRUND: Die aktuelle COVID-19-Pandemie stellt, trotz der Verfügbarkeit von Schnelltests und des Starts der Impfkampagne, die Notaufnahme weiterhin vor große Herausforderungen. Die strukturierte Erfassung von demographischen, klinischen sowie therapiebezogenen Daten stellt die Grundlage für die Erstellung evidenzbasierter Prozesse und Behandlungskonzepte dar.Darstellung der systematischen Erfassung klinischer Parameter bei Patienten mit COVID-19-Verdacht im Notaufnahmeregister ReCovER (Registry for COVID-19 in the Emergency Room) sowie deskriptive Darstellung der ersten 1000 Patienten.In zentralen Notaufnahmen (ZNA) von 6 Universitätskliniken werden kontinuierlich Daten von Patienten mit COVID-19-Verdacht, unabhängig vom Nachweis einer SARS-CoV-2-Infektion, in ein webbasiertes, anonymisiertes Register eingegeben.Zwischen dem 19.05.2020 und dem 13.01.2021 wurden 1000 Patienten in das Register eingegeben, hiervon waren 594 Patienten (59,4 %) in der SARS-CoV-2-positiven (PG) und 406 Patienten (40,6 %) in der negativen Gruppe (NG). Patienten der PG hatten signifikant weniger Vorerkrankungen und eine deutlich längere Latenz zwischen Symptombeginn und Vorstellung in der ZNA (Median 5 vs. 3 Tage), litten häufiger unter Husten, Myalgien, Fatigue sowie Geruchs/Geschmacksverlust und hatten einen signifikant höheren Sauerstoffbedarf als die NG-Patienten. Die Rate von schweren Krankheitsverläufen war in der PG signifikant erhöht und es bestanden nach Entlassung häufiger persistierende Symptome (11,1 vs. 4,6 %).Durch die multizentrische Erfassung von umfangreichen klinischen Daten zu COVID-19-Verdachtsfällen in der Notaufnahme können insbesondere auch für die Situation in Deutschland spezifische Aspekte analysiert werden. Dies ist essenziell für eine gezielte Überprüfung und Adaption international publizierter Strategien.

Acute kidney injury is a common clinical disorder resulting in significantly increased morbidity and mortality. However, despite extensive research, strategies for prevention or treatment are still lacking in routine clinical practice. Already decades ago, several preconditioning strategies (e. g. ischemic/hypoxic preconditioning and calorie restriction) have been published and their extraordinary effectiveness - especially in rodents - has raised the hope for powerful clinical tools to prevent acute kidney injury. However, the underlying mechanisms are still not completely understood and translation to the clinics has not been successful yet. In this review, the most attractive strategies and the current mechanistic concepts are introduced and discussed. Furthermore, we present clinical trials evaluating the feasibility of preconditioning in the clinical setting.

Background: The Emergency Department (ED) is directly involved in diagnosis and initial treatment of all stages of COVID-19. One major goal of the ED is to decide, whether patients need to be hospitalized or can be sent home safely. These decisions must usually be made without knowing the SARS-CoV-2 test result. Methods: We retrieved all patients who were treated at the ED of the Charite (Berlin, Germany) during the pandemic peak between March 1 and April 15, 2020 and who underwent SARS-CoV-2 testing using an oro-naso-pharyngeal swab. All patients with positive test results were characterized in detail and underwent a follow-up in hospital or outpatient setting after at least 7 days via telehealth. Logistic regression and classification and regression tree (CART) analyses were performed to identify predictors, which either justify hospital admission or confirm safe discharge. The results were validated using an independent second multiple-center cohort collated from data of four other university EDs from the ReCoVer registry. The clinical endpoint was all cause mortality or need for mechanical ventilation during index stay or after re-admission. Results: The primary test population of suspected COVID-19 consisted of n=1,255 cases, 45.2% were female (n=567). Of these, n=110 tested positive for SARS-CoV-2 (8.8%). The median age of SARS-CoV-2 positive cases was 45 years (IQR: 33-66 years), whereas the median age of the group tested negative for SARS-CoV-2 was 42 years (IQR: 30-60 years) (p=0.096). 43.6% were directly admitted to hospital care (n=48). The factors, which were significantly associated with hospitalization in univariate analysis were oxygen saturation (< 95%), age, dyspnea, time since onset of symptoms, history of cardiovascular (CV) disease, lactate, LDH and C-reactive protein (CRP). CART analysis identified the variables oxygen saturation (< 95%), dyspnea and history of cardiovascular (CV) disease were of particular importance to distinguish between high and low risk groups. If all three variables were negative, most patients were discharged from ED, and the incidence of the clinical endpoint was 0%. Vice versa if the criteria were present, the incidence of the clinical endpoint was 7.7% in patients with dyspnea only and 10.0% in patients with either CV-disease or O2-satuaration below 95%. The validation cohort confirmed the safety of discharge (1 event) and revealed an incidence of the clinical endpoint in different risk categories from 14.3% in patients with CV-disease only, 9.4% in patients with dyspnea and 18.2% in patients with O2-satuaration below 95%. Conclusions: Based on easily available variables like dyspnea, oxygen saturation, history of CV disease, approximately 25% of patients subsequently confirmed with COVID-19 can be identified for safe discharge. Further prospective studies are needed to identify more patients, who can be treated out of hospital. Funding Statement: There was no third party funding for this research. Declaration of Interests: The authors declare no conflicts of interest related to this work. Ethics Approval Statement: The Ethics Committee of the Charite – Universitatsmedizin Berlin approved the project as a sub-study of an influenza study. (EA2/204/19).

Invasive Candida infection is the fourth most common bloodstream infection. Blood cultures are the current gold standard diagnostic method, however, false negatives remain a clinical challenge. We developed a new technique measuring Candida-reactive T cells as diagnostic read-out for invasive Candida infection. In a pilot study, we followed the treatment course of a patient with an invasive Candida infection of the lumbar vertebral spine. We present the case of a 56-year-old patient with HIV-associated Burkitt lymphoma who developed septic shock during chemotherapy-induced neutropenia. For the first time, we provide flow cytometry-based diagnostics with Candida-reactive T cells for invasive candidiasis with comprehensive MRI imaging. The Candida-reactive T cell assay has potential to complement current diagnostic assays for invasive Candida infection and thus to support targeted treatment.

Background: Recent outbreaks of Candida auris further exemplify that invasive Candida infections are a substantial threat to patients and healthcare systems. Even short treatment delays are associated with higher mortality rates. Epidemiological shifts towards more resistant Candida spp. require careful surveillance. Objectives: Triggered by the emergence of C auris and by increasing antifungal resistance rates the European Confederation of Medical Mycology developed an international Candida Registry (FungiScope™ CandiReg) to allow contemporary multinational surveillance. Methods: CandiReg serves as platform for international cooperation to enhance research regarding invasive Candida infections. CandiReg uses the General Data Protection Regulation compliant data platform ClinicalSurveys.net that holds the electronic case report forms (eCRF). Data entry is supported via an interactive macro created by the software that can be accessed via any Internet browser. Results: CandiReg provides an eCRF for invasive Candida infections that can be used for a variety of studies from cohort studies on attributable mortality to evaluations of guideline adherence, offering to the investigators of the 28 ECMM member countries the opportunity to document their cases of invasive Candida infection. CandiReg allows the monitoring of epidemiology of invasive Candida infections, including monitoring of multinational outbreaks. Here, we describe the structure and management of the CandiReg platform. Conclusion: CandiReg supports the collection of clinical information and isolates to improve the knowledge on epidemiology and eventually to improve management of invasive Candida infections. CandiReg promotes international collaboration, improving the availability and quality of evidence on invasive Candida infection and contributes to improved patient management. CandiReg is an academic project and funded by ECMM via the ECMM Candida III study (PI: Hoenigl, Co‐PI Cornely; supported by Scynexis) and the University of Cologne. info:eu-repo/semantics/publishedVersion

Invasive aspergillosis (IA) is a serious hazard to haematological and critical care patients. Impactful risk factors for developing IA have been characterised; however, systematic analysis of baseline prognostic factors for treatment course of IA is missing. To understand prognostic variables, we analysed original articles identifying baseline factors that predict treatment outcome in patients with IA. PubMed database was searched for publications since database inception until May 2018. Inclusion criteria were published baseline prognostic factors present at the diagnosis of IA. In total, 58 studies from 267 centres reported 7320 patients with IA and 40 different predictors. Unfavourable predictors in medical history were kidney (7.4%, 10/136) and liver failure (3.7%, 5/136), ICU admission (3.7%, 5/136) and uncontrolled underlying disease (3.7%, 5/136). Regarding state of immunosuppression, negative outcome predictors were prolonged neutropenia (12.5%, 17/136), corticosteroid treatment (8.1%, 11/136) and graft-vs-host disease (3.7%, 5/136). On the pathogen side, relevant predictors were galactomannan positivity (8.1%, 11/136), Aspergillus terreus infection (2.2%, 3/136) and lack of amphotericin B susceptibility (1.5%, 2/136). IA-specific predictors were disseminated disease (5.1%, 7/136) and CNS involvement (2.9%, 4/136). Imaging results associated with negative outcome were multiple consolidations (2.9%, 4/136), bipulmonary lesions (2.2%, 3/136) and pleural effusion (2.2%, 3/136). At diagnosis of IA, most frequently identified predictors of outcome were neutropenia, corticosteroid use, elevated galactomannan, renal failure and disseminated disease. The predictors may be used to identify patients at high risk for treatment failure and to stratify neglected patient groups for clinical trials.

BACKGROUND: Mucormycosis is a life-threatening infection in immunocompromised patients and in haematological malignancy patients in particular. OBJECTIVES: Our aim was to develop and evaluate a scoring tool to measure adherence to current guidelines for mucormycosis. METHODS: Current guidelines of scientific societies on mucormycosis management were reviewed. We assembled diagnostic, treatment and follow-up milestones and designed the EQUAL Mucormycosis Score. The EQUAL Mucormycosis Score was evaluated in the ECMM Excellence Centres. RESULTS: An 18-item tool with one to three points per item resulted in a maximum achievable score depending on disease complexity and ranging from 25 to 32 points. Given variable patient disease course, the diagnostic score is higher in patients with positive fungal culture and biopsy, thus reflecting more decision points and higher management complexity. Eleven patients from two centres were included during the study period. A total of 200 EQUAL Mucormycosis Score points were achieved, which is 62.7% of the maximum EQUAL Mucormycosis Score of 319 points achievable in that cohort (median 18 points, range 7-27). The total score accomplished for diagnostic procedures was 112 of 165 points (67.9%), for first-line treatment 54 of 88 (61.4%) and for follow-up management 34 of 66 points (51.5%). CONCLUSIONS: The EQUAL Mucormycosis Score quantitates adherence to current guideline recommendations for mucormycosis management. With 62.7% of maximum achievable score points, a first result is obtained that may serve as a reference for future evaluations. It remains to be shown whether guideline adherence and mortality rates correlate. ispartof: JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY vol:74 issue:6 pages:1704-1712 ispartof: location:England status: published

Acute kidney injury (AKI) is a frequent and critical complication in the clinical setting. In rodents, AKI can be effectively prevented through caloric restriction (CR), which has also been shown to increase lifespan in many species. In Caenorhabditis elegans (C. elegans), longevity studies revealed that a marked CR-induced reduction of endocannabinoids may be a key mechanism. Thus, we hypothesized that regulation of endocannabinoids, particularly arachidonoyl ethanolamide (AEA), might also play a role in CR-mediated protection from renal ischemia-reperfusion injury (IRI) in mammals including humans. In male C57Bl6J mice, CR significantly reduced renal IRI and led to a significant decrease of AEA. Supplementation of AEA to near-normal serum concentrations by repetitive intraperitoneal administration in CR mice, however, did not abrogate the protective effect of CR. We also analyzed serum samples taken before and after CR from patients of three different pilot trials of dietary interventions. In contrast to mice and C. elegans, we detected an increase of AEA. We conclude that endocannabinoid levels in mice are modulated by CR, but CR-mediated renal protection does not depend on this effect. Moreover, our results indicate that modulation of endocannabinoids by CR in humans may differ fundamentally from the effects in animal models.

Background Candidemia is among the most frequent nosocomial blood stream infections and associated with considerable morbidity and mortality. Landmark case–control studies estimated an attributable mortality of 38% and 49%. After introduction of echinocandins, attributable mortality may have decreased. Methods In a case–control design, 100 consecutive, hospitalized patients with candidemia were enrolled at the University Hospital of Cologne. These cases had at least one blood culture positive for Candida spp. >48 hours post admission. We enrolled patients from January 2017 backwards until February 2014. Controls were patients without candidemia matched for age, sex, calendar year, duration of hospitalization, main admission diagnosis, and Patient Clinical Complexity Level. Risk factors for candidemia captured were malignancy, diabetes, infection other than candidemia, liver cirrhosis, hemodialysis, congestive heart failure, coronary artery disease, chronic lung disease, intensive care, mechanical ventilation, and presence of central lines. For each control patient, we considered the day of candidemia of its matched case to compare post diagnosis length of stay. We estimated attributable mortality until day 30 post candidemia diagnosis. We performed χ2-test for categorical and Student’s t-test for continuous variables, and defined a two-tailed P-value of