Effect of initial antifungal therapy on mortality among patients with bloodstream infections with different Candida species and resistance to antifungal agents: A multicentre observational study by the Turkish Fungal Infections Study Group
dc.contributor.author | Dogan, Ozlem | |
dc.contributor.author | Yesilkaya, Aysegul | |
dc.contributor.author | Menekse, Sirin | |
dc.contributor.author | Guler, Ozlem | |
dc.contributor.author | Karakoc, Cagla | |
dc.contributor.author | Cinar, Gule | |
dc.contributor.author | Kapmaz, Mahir | |
dc.contributor.author | Aydin, Mehtap | |
dc.contributor.author | Keske, Siran | |
dc.contributor.author | Sahin, Suzan | |
dc.contributor.author | Haciseyitoglu, Demet | |
dc.contributor.author | Yalcin, Demet | |
dc.contributor.author | Tekin, Suda | |
dc.contributor.author | Atac, Nazli | |
dc.contributor.author | Albayrak, Ozgur | |
dc.contributor.author | Aksu, Ekin Deniz | |
dc.contributor.author | Can, Fusun | |
dc.contributor.author | Ergonul, Onder | |
dc.contributor.pubmedID | 32335275 | en_US |
dc.date.accessioned | 2021-05-30T19:11:52Z | |
dc.date.available | 2021-05-30T19:11:52Z | |
dc.date.issued | 2020 | |
dc.description.abstract | This study aimed to describe the effect of initial antifungal therapy on patient mortality and to detail the current distribution and resistance patterns of Candida spp. among patients with candidaemia. A prospective observational study was performed among consecutive patients with candidaemia from 10 Turkish medical centres between January 2015 and November 2018. The primary outcome was 10-day mortality. Species were identified using MALDI-TOF/MS. A total of 342 patients with candidaemia were included, of which 175 (51.2%) were male and 68 (19.9%) were aged <18 years. The most common species were Candida albicans (47.4%), Candida parapsilosis (26.6%), Candida tropicalis (9.6%) and Candida glabrata (7.6%). Among all Candida spp., the 10-day case fatality rate (CFR) was 32.2%. The CFR was highest in patients with C. albicans (57.3%) and lowest in patients with C. parapsilosis (21.8%). The resistance rate to fluconazole was 13% in C. parapsilosis, with no significant effect on mortality. No resistance to echinocandins was detected. In the multivariate analysis, being in the ICU [OR = 2.1 (95% CI 1.32-3.57); P = 0.002], renal failure [OR = 2.4 (1.41-3.97); P = 0.001], total parenteral nutrition [OR = 2 (1.22-3.47); P = 0.006], C. albicans infection [OR = 1.7 (1.06-2.82); P = 0.027] and echinocandin as primary agent [OR = 0.6 (0.360.99); P = 0.047] were significantly associated with mortality. Candidaemia is a deadly infection. Fluconazole resistance is emerging, although it was not significantly related to mortality. Using an echinocandin as the primary agent could be life-saving. (c) 2020 Elsevier B.V. and International Society of Chemotherapy. All rights reserved. | en_US |
dc.identifier.issn | 0924-8579 | en_US |
dc.identifier.issue | 1 | en_US |
dc.identifier.scopus | 2-s2.0-85085523820 | en_US |
dc.identifier.uri | https://apps.webofknowledge.com/full_record.do?product=WOS&search_mode=GeneralSearch&qid=1&SID=E42tYpYSmzpg5u2W7LN&page=9&doc=444 | |
dc.identifier.uri | http://hdl.handle.net/11727/5928 | |
dc.identifier.volume | 56 | en_US |
dc.identifier.wos | 000552613500036 | en_US |
dc.language.iso | eng | en_US |
dc.relation.isversionof | 10.1016/j.ijantimicag.2020.105992 | en_US |
dc.relation.journal | INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS | en_US |
dc.relation.publicationcategory | Makale - Uluslararası Hakemli Dergi | en_US |
dc.rights | info:eu-repo/semantics/openAccess | en_US |
dc.subject | Candidaemia | en_US |
dc.subject | Echinocandins | en_US |
dc.subject | Fluconazole | en_US |
dc.subject | Azole resistance | en_US |
dc.subject | Antifungal susceptibility | en_US |
dc.subject | Clinical impact | en_US |
dc.title | Effect of initial antifungal therapy on mortality among patients with bloodstream infections with different Candida species and resistance to antifungal agents: A multicentre observational study by the Turkish Fungal Infections Study Group | en_US |
dc.type | article | en_US |