Academic Journal
Effect of initial antifungal therapy on mortality among patients with bloodstream infections with different Candida species and resistance to antifungal agents: A multicentre observational study by the Turkish Fungal Infections Study Group
| العنوان: | Effect of initial antifungal therapy on mortality among patients with bloodstream infections with different Candida species and resistance to antifungal agents: A multicentre observational study by the Turkish Fungal Infections Study Group |
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| المؤلفون: | Keske, Siran, Dogan, Ozlem, Cinar, Gule, Kapmaz, Mahir, Menekse, Sirin, YEŞİLKAYA, AYŞEGÜL, Aydin, Mehtap, GÜLER, ÖZLEM, Karakoc, Cagla, Sahin, Suzan, Haciseyitoglu, Demet, Yalcin, Demet, Atac, Nazli, Albayrak, Ozgur, Aksu, Ekin Deniz, Can, Fusun, Tekin, Suda, Ergonul, Onder |
| سنة النشر: | 2020 |
| الوصف: | This study aimed to describe the effect of initial antifungal therapy on patient mortality and to detail the current distribution and resistance patterns of Candida spp. among patients with candidaemia. A prospective observational study was performed among consecutive patients with candidaemia from 10 Turkish medical centres between January 2015 and November 2018. The primary outcome was 10-day mortality. Species were identified using MALDI-TOF/MS. A total of 342 patients with candidaemia were included, of which 175 (51.2%) were male and 68 (19.9%) were aged <18 years. The most common species were Candida albicans (47.4%), Candida parapsilosis (26.6%), Candida tropicalis (9.6%) and Candida glabrata (7.6%). Among all Candida spp., the 10-day case fatality rate (CFR) was 32.2%. The CFR was highest in patients with C. albicans (57.3%) and lowest in patients with C. parapsilosis (21.8%). The resistance rate to fluconazole was 13% in C. parapsilosis, with no significant effect on mortality. No resistance to echinocandins was detected. In the multivariate analysis, being in the ICU [OR = 2.1 (95% CI 1.32-3.57); P = 0.002], renal failure [OR = 2.4 (1.41-3.97); P = 0.001], total parenteral nutrition [OR = 2 (1.22-3.47); P = 0.006], C. albicans infection [OR = 1.7 (1.06-2.82); P = 0.027] and echinocandin as primary agent [OR = 0.6 (0.360.99); P = 0.047] were significantly associated with mortality. Candidaemia is a deadly infection. Fluconazole resistance is emerging, although it was not significantly related to mortality. Using an echinocandin as the primary agent could be life-saving. (c) 2020 Elsevier B.V. and International Society of Chemotherapy. All rights reserved. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | c5953933-6506-46f6-a289-fb585f2464a9; https://avesis.kocaeli.edu.tr/publication/details/c5953933-6506-46f6-a289-fb585f2464a9/oai |
| DOI: | 10.1016/j.ijantimicag.2020.105992 |
| الاتاحة: | https://doi.org/10.1016/j.ijantimicag.2020.105992 https://avesis.kocaeli.edu.tr/publication/details/c5953933-6506-46f6-a289-fb585f2464a9/oai |
| Rights: | info:eu-repo/semantics/closedAccess |
| رقم الانضمام: | edsbas.C5DC7405 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.ijantimicag.2020.105992 |
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