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.authorDogan, Ozlem
dc.contributor.authorYesilkaya, Aysegul
dc.contributor.authorMenekse, Sirin
dc.contributor.authorGuler, Ozlem
dc.contributor.authorKarakoc, Cagla
dc.contributor.authorCinar, Gule
dc.contributor.authorKapmaz, Mahir
dc.contributor.authorAydin, Mehtap
dc.contributor.authorKeske, Siran
dc.contributor.authorSahin, Suzan
dc.contributor.authorHaciseyitoglu, Demet
dc.contributor.authorYalcin, Demet
dc.contributor.authorTekin, Suda
dc.contributor.authorAtac, Nazli
dc.contributor.authorAlbayrak, Ozgur
dc.contributor.authorAksu, Ekin Deniz
dc.contributor.authorCan, Fusun
dc.contributor.authorErgonul, Onder
dc.contributor.pubmedID32335275en_US
dc.date.accessioned2021-05-30T19:11:52Z
dc.date.available2021-05-30T19:11:52Z
dc.date.issued2020
dc.description.abstractThis 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.issn0924-8579en_US
dc.identifier.issue1en_US
dc.identifier.scopus2-s2.0-85085523820en_US
dc.identifier.urihttps://apps.webofknowledge.com/full_record.do?product=WOS&search_mode=GeneralSearch&qid=1&SID=E42tYpYSmzpg5u2W7LN&page=9&doc=444
dc.identifier.urihttp://hdl.handle.net/11727/5928
dc.identifier.volume56en_US
dc.identifier.wos000552613500036en_US
dc.language.isoengen_US
dc.relation.isversionof10.1016/j.ijantimicag.2020.105992en_US
dc.relation.journalINTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTSen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergien_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectCandidaemiaen_US
dc.subjectEchinocandinsen_US
dc.subjectFluconazoleen_US
dc.subjectAzole resistanceen_US
dc.subjectAntifungal susceptibilityen_US
dc.subjectClinical impacten_US
dc.titleEffect 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 Groupen_US
dc.typearticleen_US

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