High incidence of candidaemia in a nationwide cohort: Underlying diseases, risk factors and mortality
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High incidence of candidaemia in a nationwide cohort : Underlying diseases, risk factors and mortality. / Lausch, K. R.; Søgaard, M.; Rosenvinge, F. S.; Johansen, H. K.; Boysen, T.; Røder, B.; Mortensen, K. L.; Nielsen, L.; Lemming, L.; Olesen, B.; Leitz, C.; Kristensen, L.; Dzajic, E.; Østergaard, L.; Schønheyder, H. C.; Arendrup, M. C.
In: International Journal of Infectious Diseases, Vol. 76, 2018, p. 58-63.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - High incidence of candidaemia in a nationwide cohort
T2 - Underlying diseases, risk factors and mortality
AU - Lausch, K. R.
AU - Søgaard, M.
AU - Rosenvinge, F. S.
AU - Johansen, H. K.
AU - Boysen, T.
AU - Røder, B.
AU - Mortensen, K. L.
AU - Nielsen, L.
AU - Lemming, L.
AU - Olesen, B.
AU - Leitz, C.
AU - Kristensen, L.
AU - Dzajic, E.
AU - Østergaard, L.
AU - Schønheyder, H. C.
AU - Arendrup, M. C.
PY - 2018
Y1 - 2018
N2 - Background: Denmark has a high incidence rate of candidaemia. A Nordic study suggested a higher Danish prevalence of haematological malignancies as an underlying reason. This nationwide study ascertained clinical characteristics of Danish candidaemia patients and investigated potential factors contributing to the high incidence and mortality. Methods: Microbiological and clinical data for candidaemia patients in 2010-2011 were retrieved. 30-day mortality was estimated by hazard ratios (HR) with 95% confidence intervals (CI, Cox regression). Results: Data were available for 912/973 candidaemia episodes (93.7%). Intensive care unit (ICU) held the largest share of patients (43.2%). Prevalent host factors were multi-morbidity (≥2 underlying diseases, 74.2%) and gastrointestinal disease (52.5%). Haematological disease was infrequent (7.8%). Risk factors included antibiotic exposure (90.5%), CVC (71.9%) and Candida colonisation (66.7%). 30-day mortality was 43.4%, and 53.6% in ICU. Mortality was lower for patients with recent abdominal surgery (HR 0.70, 95% CI: 0.54-0.92). Conclusion: A substantial prevalence of multi-morbidity and a high 30-day mortality was found. We hypothesise, that an increasing population of severely ill patients with prolonged supportive treatment and microbiological testing may in part explain the high candidaemia incidence in Denmark. Nationwide studies are warranted to clarify this issue.
AB - Background: Denmark has a high incidence rate of candidaemia. A Nordic study suggested a higher Danish prevalence of haematological malignancies as an underlying reason. This nationwide study ascertained clinical characteristics of Danish candidaemia patients and investigated potential factors contributing to the high incidence and mortality. Methods: Microbiological and clinical data for candidaemia patients in 2010-2011 were retrieved. 30-day mortality was estimated by hazard ratios (HR) with 95% confidence intervals (CI, Cox regression). Results: Data were available for 912/973 candidaemia episodes (93.7%). Intensive care unit (ICU) held the largest share of patients (43.2%). Prevalent host factors were multi-morbidity (≥2 underlying diseases, 74.2%) and gastrointestinal disease (52.5%). Haematological disease was infrequent (7.8%). Risk factors included antibiotic exposure (90.5%), CVC (71.9%) and Candida colonisation (66.7%). 30-day mortality was 43.4%, and 53.6% in ICU. Mortality was lower for patients with recent abdominal surgery (HR 0.70, 95% CI: 0.54-0.92). Conclusion: A substantial prevalence of multi-morbidity and a high 30-day mortality was found. We hypothesise, that an increasing population of severely ill patients with prolonged supportive treatment and microbiological testing may in part explain the high candidaemia incidence in Denmark. Nationwide studies are warranted to clarify this issue.
KW - Candida
KW - Candidaemia
KW - Epidemiology
KW - Mortality
KW - Outcome
U2 - 10.1016/j.ijid.2018.08.010
DO - 10.1016/j.ijid.2018.08.010
M3 - Journal article
C2 - 30176293
AN - SCOPUS:85053858840
VL - 76
SP - 58
EP - 63
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
SN - 1201-9712
ER -
ID: 217391725