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Abstract
Background
The European Confederation of Medical Mycology (ECMM) collected data on epidemiology, risk factors, treatment, and outcomes of culture proven candidemia across Europe in order to assess how adherence to guideline recommendations correlate with outcomes.
Methods
Each participating hospital (number of eligible hospitals per country determined by population size) included the first ~10 culture proven candidemia cases after 01-July-2018 and entered data into the ECMM Candida III database on the FungiScope® platform. EQUAL Candida Scores reflecting adherence to recommendations of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Infectious Disease Society of America (IDSA) Guidelines were assessed.
Findings
A total of 632 candidemia cases were included from 60 institutions in 20 European countries. Overall mortality was 46.4% (286/617), and older age, intensive care unit (ICU) admission and rare Candida spp. as causative pathogens were independent predictors of mortality in Cox regression analysis. EQUAL Candida Score was evaluable for 589 cases with candidemia and remained an independent predictor of mortality in the multivariable Cox regression analyses after adjusting for age, ICU admission and rare Candida spp. (adjusted hazard ratios between 1.074 and 1.087 per 1 point decrease; p
Interpretation
While overall mortality of candidemia was 46%, our study indicates that adherence to clinical guideline recommendations, reflected by higher EQUAL Candida Scores, may increase survival. Echinocandin treatment was associated with increased overall survival, but also longer duration of hospitalization (hospitalization was prolonged only for completing treatment in 16%).
The European Confederation of Medical Mycology (ECMM) collected data on epidemiology, risk factors, treatment, and outcomes of culture proven candidemia across Europe in order to assess how adherence to guideline recommendations correlate with outcomes.
Methods
Each participating hospital (number of eligible hospitals per country determined by population size) included the first ~10 culture proven candidemia cases after 01-July-2018 and entered data into the ECMM Candida III database on the FungiScope® platform. EQUAL Candida Scores reflecting adherence to recommendations of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Infectious Disease Society of America (IDSA) Guidelines were assessed.
Findings
A total of 632 candidemia cases were included from 60 institutions in 20 European countries. Overall mortality was 46.4% (286/617), and older age, intensive care unit (ICU) admission and rare Candida spp. as causative pathogens were independent predictors of mortality in Cox regression analysis. EQUAL Candida Score was evaluable for 589 cases with candidemia and remained an independent predictor of mortality in the multivariable Cox regression analyses after adjusting for age, ICU admission and rare Candida spp. (adjusted hazard ratios between 1.074 and 1.087 per 1 point decrease; p
Interpretation
While overall mortality of candidemia was 46%, our study indicates that adherence to clinical guideline recommendations, reflected by higher EQUAL Candida Scores, may increase survival. Echinocandin treatment was associated with increased overall survival, but also longer duration of hospitalization (hospitalization was prolonged only for completing treatment in 16%).
| Original language | English |
|---|---|
| Journal | The Lancet |
| Publication status | Accepted/In press - 30 Sept 2022 |
Fingerprint
Dive into the research topics of 'Guideline adherence predicts Survival of Candidemia in Europe: Results from the ECMM Candida III multinational European Cohort Study'. Together they form a unique fingerprint.Projects
- 1 Active
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MFIG: Manchester Fungal Infection Group (MFIG)
Bromley, M. (PI), Bertuzzi, M. (PI), Gago, S. (PI), Denning, D. (PI), Kosmidis, C. (PI), Bowyer, P. (PI), Amich Elias, J. (PI), Richardson, M. (PI), Richardson, R. (PI), Van Rhijn, N. (PI) & Bottery, M. (PI)
15/08/13 → …
Project: Research