AI Article Synopsis
- The study investigates the effect of inappropriate antifungal treatment on 30-day mortality rates in patients with Candida Bloodstream Infection (CBSI), revealing a high mortality of 38%.
- Data was gathered from two healthcare centers over six years, analyzing 149 CBSI episodes and identifying factors like severe sepsis and cirrhosis as significant predictors of mortality.
- Findings suggest that proper antifungal treatment according to updated guidelines did not significantly affect mortality, indicating that the severity of the infection and underlying health issues are more critical factors.
Article Abstract
Background: The mortality of Candida Bloodstream Infection (CBSI) remains high. Antifungal susceptibility breakpoints were recently updated for Candida species, the impact remains unknown. In this study we evaluated the impact of inappropriate antifungal treatment according to recent breakpoints on 30-day mortality of CBSI.
Methods: From June 2008 to July 2014, data on CBSI episodes from two tertiary-care centers, treated > 72 h were analyzed. Antifungal therapy and 30-day mortality were registered. Inappropriate antifungal treatment according to current Clinical & Laboratory Standards Institute (CLSI) breakpoints was adjusted with 30-day mortality-related co-variates.
Results: One hundred forty-nine episodes of CBSI were analyzed. The most frequent species were: C. albicans (40%), C. tropicalis (23%) and C. glabrata complex (20%). According to the 2012 CLSI, 10.7% received inappropriate treatment. The 30-day mortality was 38%; severe sepsis [Odds ratio (OR) 3.4; 95% CI 1.3-8.4], cirrhosis (OR 36; 95% CI 12.2-605), early central venous catheter removal (OR 0.23; 95% CI 0.08-0.66) and previous antifungal therapy (OR 0.15; 95%CI 0.03-0.62), were associated with 30-day mortality by multivariate analysis. Inappropriate antifungal treatment was not (OR 0.19; 95% CI 0.03-1.2).
Conclusions: Appropriate antifungal therapy according to CLSI 2012 did not have an impact on mortality. Mortality of CBSI remains high due to disease severity and comorbidities; early antifungal therapy and catheter removal may reduce it.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719515 | PMC |
| http://dx.doi.org/10.1186/s12879-017-2846-2 | DOI Listing |
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