Caitlin Livia Keighley1,2,3, Alun Pope4, Deborah J E Marriott5, Belinda Chapman6, Narin Bak7, Kathryn Daveson8, Krispin Hajkowicz9, Catriona Halliday1, Karina Kennedy8, Sarah Kidd10, Tania C Sorrell2,3,6, Neil Underwood11, Sebastiaan van Hal12, Monica A Slavin13, Sharon C-A Chen1,2,3,6. 1. Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, New South Wales Health Pathology, Sydney, NSW, Australia. 2. Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, NSW, Australia. 3. The Department of Infectious Diseases, Westmead Hospital, Sydney, NSW, Australia. 4. Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia. 5. Department of Microbiology and Infectious Diseases, St. Vincent's Hospital, Sydney, NSW, Australia. 6. Westmead Institute for Medical Research, Westmead, NSW, Australia. 7. Department of Infectious Diseases, Royal Adelaide Hospital, Adelaide, SA, Australia. 8. Department of Infectious Diseases and Microbiology, Canberra Hospital, Australian National University Medical School, Canberra, ACT, Australia. 9. Department of Infectious Diseases, School of Medicine, Royal Brisbane and Women's Hospital, University of Queensland, Brisbane, QLD, Australia. 10. National Mycology Reference Centre, SA Pathology, Adelaide, SA, Australia. 11. Infection Management Services, Princess Alexandra Hospital, Brisbane, QLD, Australia. 12. Department of Infectious Diseases and Microbiology, New South Wales Health Pathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia. 13. Department of Infectious Diseases, Peter MacCallum Cancer Centre, National Centre for Infections in Cancer, Melbourne, VIC, Australia.
Abstract
OBJECTIVES: Candidaemia carries a mortality of up to 40% and may be related to increasing complexity of medical care. Here, we determined risk factors for the development of candidaemia. METHODS: We conducted a prospective, multi-centre, case-control study over 12 months. Cases were aged ≥18 years with at least one blood culture positive for Candida spp. Each case was matched with two controls, by age within 10 years, admission within 6 months, admitting unit, and admission duration at least as long as the time between admission and onset of candidaemia. RESULTS: A total of 118 incident cases and 236 matched controls were compared. By multivariate analysis, risk factors for candidaemia included neutropenia, solid organ transplant, significant liver, respiratory or cardiovascular disease, recent gastrointestinal, biliary or urological surgery, central venous access device, intravenous drug use, urinary catheter and carbapenem receipt. CONCLUSIONS: Risk factors for candidaemia derive from the infection source, carbapenem use, host immune function and organ-based co-morbidities. Preventive strategies should target iatrogenic disruption of mucocutaneous barriers and intravenous drug use.
OBJECTIVES: Candidaemia carries a mortality of up to 40% and may be related to increasing complexity of medical care. Here, we determined risk factors for the development of candidaemia. METHODS: We conducted a prospective, multi-centre, case-control study over 12 months. Cases were aged ≥18 years with at least one blood culture positive for Candida spp. Each case was matched with two controls, by age within 10 years, admission within 6 months, admitting unit, and admission duration at least as long as the time between admission and onset of candidaemia. RESULTS: A total of 118 incident cases and 236 matched controls were compared. By multivariate analysis, risk factors for candidaemia included neutropenia, solid organ transplant, significant liver, respiratory or cardiovascular disease, recent gastrointestinal, biliary or urological surgery, central venous access device, intravenous drug use, urinary catheter and carbapenem receipt. CONCLUSIONS: Risk factors for candidaemia derive from the infection source, carbapenem use, host immune function and organ-based co-morbidities. Preventive strategies should target iatrogenic disruption of mucocutaneous barriers and intravenous drug use.
Authors: José Francisco García-Rodríguez; Belén Bardán-García; Pedro Miguel Juiz-González; Laura Vilariño-Maneiro; Hortensia Álvarez-Díaz; Ana Mariño-Callejo Journal: Antibiotics (Basel) Date: 2020-12-26
Authors: Caitlin Keighley; Mailie Gall; Sebastiaan J van Hal; Catriona L Halliday; Louis Yi Ann Chai; Kean Lee Chew; Chayanika Biswas; Monica A Slavin; Wieland Meyer; Vitali Sintchenko; Sharon C A Chen Journal: J Fungi (Basel) Date: 2022-08-23