Predictors for Prolonged Hospital Stay Solely to Complete Intravenous Antifungal Treatment in Patients with Candidemia: Results from the ECMM Candida III Multinational European Observational Cohort Study

M Egger; J Salmanton-García; A Barac; JP Gangneux; H Guegan; V Arsic-Arsenijevic; T Matos; R Tomazin; N Klimko; M Bassetti; H Hammarström; EFJ Meijer; JF Meis; J Prattes; R Krause; OR Sipahi; U Scharmann; PL White; G Desoubeaux; J García-Rodríguez; C Garcia-Vidal; S Martín-Pérez; M Ruiz; M Tumbarello; AF Talento; B Rogers; K Lagrou; J van Praet; S Arikan-Akdagli; MC Arendrup; P Koehler; OA Cornely; M Hoenigl; ECMM Candida III Study Group; Ana Alastruey-izquierdo; Nick Alexander de Jonge; Tihana Bicanic; Ola Blennow; Blandine Denis; Nina Khanna; Cornelia Lass-Flörl; Clare V. Logan; Laura Loughlin; Volkan Özenci; Zdenek Zdenek; Laman Rahimli; Riina Rautemaa-Richardson; Joerg Steinmann; Igor Stoma; Janina Trauth; François Danion; Jochem B. Buil; Julio Dávila-Valls; Eric Van Wijngaerden

doi:10.1007/s11046-023-00776-4

Predictors for Prolonged Hospital Stay Solely to Complete Intravenous Antifungal Treatment in Patients with Candidemia: Results from the ECMM Candida III Multinational European Observational Cohort Study

M Egger, J Salmanton-García, A Barac, JP Gangneux, H Guegan, V Arsic-Arsenijevic, T Matos, R Tomazin, N Klimko, M Bassetti, H Hammarström, EFJ Meijer, JF Meis, J Prattes, R Krause, OR Sipahi, U Scharmann, PL White, G Desoubeaux, J García-RodríguezC Garcia-Vidal, S Martín-Pérez, M Ruiz, M Tumbarello, AF Talento, B Rogers, K Lagrou, J van Praet, S Arikan-Akdagli, MC Arendrup, P Koehler, OA Cornely, M Hoenigl, ECMM Candida III Study Group, Ana Alastruey-izquierdo, Nick Alexander de Jonge, Tihana Bicanic, Ola Blennow, Blandine Denis, Nina Khanna, Cornelia Lass-Flörl, Clare V. Logan, Laura Loughlin, Volkan Özenci, Zdenek Zdenek, Laman Rahimli, Riina Rautemaa-Richardson , Joerg Steinmann, Igor Stoma, Janina Trauth, François Danion, Jochem B. Buil, Julio Dávila-Valls, Eric Van Wijngaerden

Division of Evolution, Infection and Genomics

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: To date, azoles represent the only viable option for oral treatment of invasive Candida infections, while rates of azole resistance among non-albicans Candida spp. continue to increase. The objective of this sub-analysis of the European multicenter observational cohort study Candida III was to describe demographical and clinical characteristics of the cohort requiring prolonged hospitalization solely to complete intravenous (iv) antifungal treatment (AF Tx).

METHODS: Each participating hospital (number of eligible hospitals per country determined by population size) included the first ~ 10 blood culture proven adult candidemia cases occurring consecutively after July 1st, 2018, and treating physicians answered the question on whether hospital stay was prolonged only for completion of intravenous antifungal therapy. Descriptive analyses as well as binary logistic regression was used to assess for predictors of prolonged hospitalization solely to complete iv AF Tx.

FINDINGS: Hospital stay was prolonged solely for the completion of iv AF Tx in 16% (100/621) of candidemia cases by a median of 16 days (IQR 8 - 28). In the multivariable model, initial echinocandin treatment was a positive predictor for prolonged hospitalization to complete iv AF Tx (aOR 2.87, 95% CI 1.55 - 5.32, p < 0.001), while (i) neutropenia, (ii) intensive care unit admission, (iii) catheter related candidemia, (iv) total parenteral nutrition, and (v) C. parapsilosis as causative pathogen were found to be negative predictors (aOR 0.22 - 0.45; p < 0.03).

INTERPRETATION: Hospital stays were prolonged due to need of iv AF Tx in 16% of patients with candidemia. Those patients were more likely to receive echinocandins as initial treatment and were less severely ill and less likely infected with C. parapsilosis.

Original language	English
Pages (from-to)	983-994
Number of pages	12
Journal	Mycopathologia
Volume	188
Issue number	6
Early online date	11 Aug 2023
DOIs	https://doi.org/10.1007/s11046-023-00776-4
Publication status	Published - 1 Dec 2023

Keywords

Candida albicans
Candida auris
Candida glabrata
Candida parapsilosis
Candida tropicalis
Guidelines
Mortality

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Egger, M., Salmanton-García, J., Barac, A., Gangneux, JP., Guegan, H., Arsic-Arsenijevic, V., Matos, T., Tomazin, R., Klimko, N., Bassetti, M., Hammarström, H., Meijer, EFJ., Meis, JF., Prattes, J., Krause, R., Sipahi, OR., Scharmann, U., White, PL., Desoubeaux, G., ... Van Wijngaerden, E. (2023). Predictors for Prolonged Hospital Stay Solely to Complete Intravenous Antifungal Treatment in Patients with Candidemia: Results from the ECMM Candida III Multinational European Observational Cohort Study. Mycopathologia, 188(6), 983-994. https://doi.org/10.1007/s11046-023-00776-4

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title = "Predictors for Prolonged Hospital Stay Solely to Complete Intravenous Antifungal Treatment in Patients with Candidemia: Results from the ECMM Candida III Multinational European Observational Cohort Study",

abstract = "BACKGROUND: To date, azoles represent the only viable option for oral treatment of invasive Candida infections, while rates of azole resistance among non-albicans Candida spp. continue to increase. The objective of this sub-analysis of the European multicenter observational cohort study Candida III was to describe demographical and clinical characteristics of the cohort requiring prolonged hospitalization solely to complete intravenous (iv) antifungal treatment (AF Tx).METHODS: Each participating hospital (number of eligible hospitals per country determined by population size) included the first ~ 10 blood culture proven adult candidemia cases occurring consecutively after July 1st, 2018, and treating physicians answered the question on whether hospital stay was prolonged only for completion of intravenous antifungal therapy. Descriptive analyses as well as binary logistic regression was used to assess for predictors of prolonged hospitalization solely to complete iv AF Tx.FINDINGS: Hospital stay was prolonged solely for the completion of iv AF Tx in 16% (100/621) of candidemia cases by a median of 16 days (IQR 8 - 28). In the multivariable model, initial echinocandin treatment was a positive predictor for prolonged hospitalization to complete iv AF Tx (aOR 2.87, 95% CI 1.55 - 5.32, p < 0.001), while (i) neutropenia, (ii) intensive care unit admission, (iii) catheter related candidemia, (iv) total parenteral nutrition, and (v) C. parapsilosis as causative pathogen were found to be negative predictors (aOR 0.22 - 0.45; p < 0.03).INTERPRETATION: Hospital stays were prolonged due to need of iv AF Tx in 16% of patients with candidemia. Those patients were more likely to receive echinocandins as initial treatment and were less severely ill and less likely infected with C. parapsilosis.",

keywords = "Candida albicans, Candida auris, Candida glabrata, Candida parapsilosis, Candida tropicalis, Guidelines, Mortality",

author = "M Egger and J Salmanton-Garc{\'i}a and A Barac and JP Gangneux and H Guegan and V Arsic-Arsenijevic and T Matos and R Tomazin and N Klimko and M Bassetti and H Hammarstr{\"o}m and EFJ Meijer and JF Meis and J Prattes and R Krause and OR Sipahi and U Scharmann and PL White and G Desoubeaux and J Garc{\'i}a-Rodr{\'i}guez and C Garcia-Vidal and S Mart{\'i}n-P{\'e}rez and M Ruiz and M Tumbarello and AF Talento and B Rogers and K Lagrou and {van Praet}, J and S Arikan-Akdagli and MC Arendrup and P Koehler and OA Cornely and M Hoenigl and {ECMM Candida III Study Group} and Ana Alastruey-izquierdo and {de Jonge}, {Nick Alexander} and Tihana Bicanic and Ola Blennow and Blandine Denis and Nina Khanna and Cornelia Lass-Fl{\"o}rl and Logan, {Clare V.} and Laura Loughlin and Volkan {\"O}zenci and Zdenek Zdenek and Laman Rahimli and Riina Rautemaa-Richardson and Joerg Steinmann and Igor Stoma and Janina Trauth and Fran{\c c}ois Danion and Buil, {Jochem B.} and Julio D{\'a}vila-Valls and {Van Wijngaerden}, Eric",

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doi = "10.1007/s11046-023-00776-4",

language = "English",

volume = "188",

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Egger, M, Salmanton-García, J, Barac, A, Gangneux, JP, Guegan, H, Arsic-Arsenijevic, V, Matos, T, Tomazin, R, Klimko, N, Bassetti, M, Hammarström, H, Meijer, EFJ, Meis, JF, Prattes, J, Krause, R, Sipahi, OR, Scharmann, U, White, PL, Desoubeaux, G, García-Rodríguez, J, Garcia-Vidal, C, Martín-Pérez, S, Ruiz, M, Tumbarello, M, Talento, AF, Rogers, B, Lagrou, K, van Praet, J, Arikan-Akdagli, S, Arendrup, MC, Koehler, P, Cornely, OA, Hoenigl, M, ECMM Candida III Study Group, Alastruey-izquierdo, A, de Jonge, NA, Bicanic, T, Blennow, O, Denis, B, Khanna, N, Lass-Flörl, C, Logan, CV, Loughlin, L, Özenci, V, Zdenek, Z, Rahimli, L, Rautemaa-Richardson , R, Steinmann, J, Stoma, I, Trauth, J, Danion, F, Buil, JB, Dávila-Valls, J & Van Wijngaerden, E 2023, 'Predictors for Prolonged Hospital Stay Solely to Complete Intravenous Antifungal Treatment in Patients with Candidemia: Results from the ECMM Candida III Multinational European Observational Cohort Study', Mycopathologia, vol. 188, no. 6, pp. 983-994. https://doi.org/10.1007/s11046-023-00776-4

Predictors for Prolonged Hospital Stay Solely to Complete Intravenous Antifungal Treatment in Patients with Candidemia: Results from the ECMM Candida III Multinational European Observational Cohort Study. / Egger, M; Salmanton-García, J; Barac, A et al.
In: Mycopathologia, Vol. 188, No. 6, 01.12.2023, p. 983-994.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Predictors for Prolonged Hospital Stay Solely to Complete Intravenous Antifungal Treatment in Patients with Candidemia

T2 - Results from the ECMM Candida III Multinational European Observational Cohort Study

AU - Egger, M

AU - Salmanton-García, J

AU - Barac, A

AU - Gangneux, JP

AU - Guegan, H

AU - Arsic-Arsenijevic, V

AU - Matos, T

AU - Tomazin, R

AU - Klimko, N

AU - Bassetti, M

AU - Hammarström, H

AU - Meijer, EFJ

AU - Meis, JF

AU - Prattes, J

AU - Krause, R

AU - Sipahi, OR

AU - Scharmann, U

AU - White, PL

AU - Desoubeaux, G

AU - García-Rodríguez, J

AU - Garcia-Vidal, C

AU - Martín-Pérez, S

AU - Ruiz, M

AU - Tumbarello, M

AU - Talento, AF

AU - Rogers, B

AU - Lagrou, K

AU - van Praet, J

AU - Arikan-Akdagli, S

AU - Arendrup, MC

AU - Koehler, P

AU - Cornely, OA

AU - Hoenigl, M

AU - ECMM Candida III Study Group

AU - Alastruey-izquierdo, Ana

AU - de Jonge, Nick Alexander

AU - Bicanic, Tihana

AU - Blennow, Ola

AU - Denis, Blandine

AU - Khanna, Nina

AU - Lass-Flörl, Cornelia

AU - Logan, Clare V.

AU - Loughlin, Laura

AU - Özenci, Volkan

AU - Zdenek, Zdenek

AU - Rahimli, Laman

AU - Rautemaa-Richardson , Riina

AU - Steinmann, Joerg

AU - Stoma, Igor

AU - Trauth, Janina

AU - Danion, François

AU - Buil, Jochem B.

AU - Dávila-Valls, Julio

AU - Van Wijngaerden, Eric

PY - 2023/12/1

Y1 - 2023/12/1

N2 - BACKGROUND: To date, azoles represent the only viable option for oral treatment of invasive Candida infections, while rates of azole resistance among non-albicans Candida spp. continue to increase. The objective of this sub-analysis of the European multicenter observational cohort study Candida III was to describe demographical and clinical characteristics of the cohort requiring prolonged hospitalization solely to complete intravenous (iv) antifungal treatment (AF Tx).METHODS: Each participating hospital (number of eligible hospitals per country determined by population size) included the first ~ 10 blood culture proven adult candidemia cases occurring consecutively after July 1st, 2018, and treating physicians answered the question on whether hospital stay was prolonged only for completion of intravenous antifungal therapy. Descriptive analyses as well as binary logistic regression was used to assess for predictors of prolonged hospitalization solely to complete iv AF Tx.FINDINGS: Hospital stay was prolonged solely for the completion of iv AF Tx in 16% (100/621) of candidemia cases by a median of 16 days (IQR 8 - 28). In the multivariable model, initial echinocandin treatment was a positive predictor for prolonged hospitalization to complete iv AF Tx (aOR 2.87, 95% CI 1.55 - 5.32, p < 0.001), while (i) neutropenia, (ii) intensive care unit admission, (iii) catheter related candidemia, (iv) total parenteral nutrition, and (v) C. parapsilosis as causative pathogen were found to be negative predictors (aOR 0.22 - 0.45; p < 0.03).INTERPRETATION: Hospital stays were prolonged due to need of iv AF Tx in 16% of patients with candidemia. Those patients were more likely to receive echinocandins as initial treatment and were less severely ill and less likely infected with C. parapsilosis.

AB - BACKGROUND: To date, azoles represent the only viable option for oral treatment of invasive Candida infections, while rates of azole resistance among non-albicans Candida spp. continue to increase. The objective of this sub-analysis of the European multicenter observational cohort study Candida III was to describe demographical and clinical characteristics of the cohort requiring prolonged hospitalization solely to complete intravenous (iv) antifungal treatment (AF Tx).METHODS: Each participating hospital (number of eligible hospitals per country determined by population size) included the first ~ 10 blood culture proven adult candidemia cases occurring consecutively after July 1st, 2018, and treating physicians answered the question on whether hospital stay was prolonged only for completion of intravenous antifungal therapy. Descriptive analyses as well as binary logistic regression was used to assess for predictors of prolonged hospitalization solely to complete iv AF Tx.FINDINGS: Hospital stay was prolonged solely for the completion of iv AF Tx in 16% (100/621) of candidemia cases by a median of 16 days (IQR 8 - 28). In the multivariable model, initial echinocandin treatment was a positive predictor for prolonged hospitalization to complete iv AF Tx (aOR 2.87, 95% CI 1.55 - 5.32, p < 0.001), while (i) neutropenia, (ii) intensive care unit admission, (iii) catheter related candidemia, (iv) total parenteral nutrition, and (v) C. parapsilosis as causative pathogen were found to be negative predictors (aOR 0.22 - 0.45; p < 0.03).INTERPRETATION: Hospital stays were prolonged due to need of iv AF Tx in 16% of patients with candidemia. Those patients were more likely to receive echinocandins as initial treatment and were less severely ill and less likely infected with C. parapsilosis.

KW - Candida albicans

KW - Candida auris

KW - Candida glabrata

KW - Candida parapsilosis

KW - Candida tropicalis

KW - Guidelines

KW - Mortality

UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pure_starter&SrcAuth=WosAPI&KeyUT=WOS:001046055400001&DestLinkType=FullRecord&DestApp=WOS

U2 - 10.1007/s11046-023-00776-4

DO - 10.1007/s11046-023-00776-4

M3 - Article

C2 - 37566212

SN - 0301-486X

VL - 188

SP - 983

EP - 994

JO - Mycopathologia

JF - Mycopathologia

IS - 6

ER -

Egger M, Salmanton-García J, Barac A, Gangneux JP, Guegan H, Arsic-Arsenijevic V et al. Predictors for Prolonged Hospital Stay Solely to Complete Intravenous Antifungal Treatment in Patients with Candidemia: Results from the ECMM Candida III Multinational European Observational Cohort Study. Mycopathologia. 2023 Dec 1;188(6):983-994. Epub 2023 Aug 11. doi: 10.1007/s11046-023-00776-4

Predictors for Prolonged Hospital Stay Solely to Complete Intravenous Antifungal Treatment in Patients with Candidemia: Results from the ECMM Candida III Multinational European Observational Cohort Study

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