BACKGROUND: Patients with extensive burns are at risk of developing candidemia. OBJECTIVES: To identify potentially modifiable risk factors and outcomes of candidemia in critically ill burns patients. PATIENTS AND METHODS: Retrospective matched cohort study including adult burns patients. Patients who developed candidemia were matched with burns patients with Candida spp colonisation and sepsis or septic shock without candidemia in a ratio of 1:3 (same severity scores and colonisation index). Univariate and multiple regression analyses were performed. RESULTS: Of 130 severely burned patients with Candida spp colonisation and at least one episode of sepsis or septic shock, 14 were diagnosed with candidemia. In the candidemia group, patients had a median (IQR) total burns surface area (TBSA) of 57 (38-68)%, SAPSII of 43 (36-58) and ABSI of 11 (8-13). Multiple regression analysis showed that only duration of prior antibiotic therapy was independently associated with candidemia. ICU mortality was higher in the candidemia group (71% vs 35% [P = 0.02]). The log-rank test for 28-day mortality comparing patients with candidemia treated with an empirical strategy vs a curative strategy did not reach significance (P = 0.056). CONCLUSIONS: Burns patients having received recent antibiotherapy have a higher risk of candidemia. Antifungal strategies did not influence outcome in this series.
BACKGROUND:Patients with extensive burns are at risk of developing candidemia. OBJECTIVES: To identify potentially modifiable risk factors and outcomes of candidemia in critically ill burnspatients. PATIENTS AND METHODS: Retrospective matched cohort study including adult burns patients. Patients who developed candidemia were matched with burns patients with Candida spp colonisation and sepsis or septic shock without candidemia in a ratio of 1:3 (same severity scores and colonisation index). Univariate and multiple regression analyses were performed. RESULTS: Of 130 severely burned patients with Candida spp colonisation and at least one episode of sepsis or septic shock, 14 were diagnosed with candidemia. In the candidemia group, patients had a median (IQR) total burns surface area (TBSA) of 57 (38-68)%, SAPSII of 43 (36-58) and ABSI of 11 (8-13). Multiple regression analysis showed that only duration of prior antibiotic therapy was independently associated with candidemia. ICU mortality was higher in the candidemia group (71% vs 35% [P = 0.02]). The log-rank test for 28-day mortality comparing patients with candidemia treated with an empirical strategy vs a curative strategy did not reach significance (P = 0.056). CONCLUSIONS: Burns patients having received recent antibiotherapy have a higher risk of candidemia. Antifungal strategies did not influence outcome in this series.
Authors: François Dépret; Boris Farny; Mathieu Jeanne; Kada Klouche; Thomas Leclerc; Karine Nouette-Gaulain; Olivier Pantet; Francis Rémerand; Antoine Roquilly; Anne-Françoise Rousseau; Simon Sztajnic; Sandrine Wiramus; Eric Vicaut; Matthieu Legrand Journal: Trials Date: 2020-11-25 Impact factor: 2.279
Authors: Matteo Bassetti; Antonio Vena; Daniele R Giacobbe; Cecilia Trucchi; Filippo Ansaldi; Massimo Antonelli; Vaclava Adamkova; Cristiano Alicino; Maria-Panagiota Almyroudi; Enora Atchade; Anna M Azzini; Pierluigi Brugnaro; Novella Carannante; Maddalena Peghin; Marco Berruti; Alessia Carnelutti; Nadia Castaldo; Silvia Corcione; Andrea Cortegiani; George Dimopoulos; Simon Dubler; José L García-Garmendia; Massimo Girardis; Oliver A Cornely; Stefano Ianniruberto; Bart Jan Kullberg; Katrien Lagrou; Clement Lebihan; Roberto Luzzati; Manu Malbrain; Maria Merelli; Ana J Marques; Ignacio Martin-Loeches; Alessio Mesini; José-Artur Paiva; Santi Maurizio Raineri; Riina Rautemaa-Richardson; Jeroen Schouten; Herbert Spapen; Polychronis Tasioudis; Jean-François Timsit; Valentino Tisa; Mario Tumbarello; Charlotte H S B Van den Berg; Benoit Veber; Mario Venditti; Guillaume Voiriot; Joost Wauters; Nathalie Zappella; Philippe Montravers Journal: Infect Dis Ther Date: 2022-02-19