Excess Mortality, Hospital Stay, and Cost Due to Candidemia: A Case-Control Study Using Data From Population-Based Candidemia Surveillance

Morgan, Juliette; Meltzer, Martin I.; Plikaytis, Brian D.; Sofair, André N.; Huie-White, Sharon; Wilcox, S. J.; Harrison, Lee H.; Seaberg, Eric C.; Hajjeh, Rana; Teutsch, Steven M.

doi:10.1086/502581

Cited by 385 publications

(257 citation statements)

References 27 publications

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“…Trichosporon was reported as the second most common cause of disseminated yeast infections which can also cause to break through under CAS treatment as in our study [30]. Although catheter removal is recommended after identifying the fungemia, catheter removal by 24 or 48 h after treatment initiation was reported to have no effect on overall treatment response, mortality and mycological eradication in 842 patients with candidemia [31][32][33]. CAS therapy is recommended by ESCMID Fungal Infection Study Group if catheter retention is needed due to clinical conditions of the patient [34].…”

Section: Discussionmentioning

confidence: 54%

Novel Antifungal Drugs Against Fungal Pathogens: Do They Provide Promising Results for Treatment?

Gedık

Şimşek

Yıldırmak

et al. 2014

Indian J Hematol Blood Transfus

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The febrile neutropenia episodes of hematological patients and their outcomes were evaluated with respect to fungal pathogens and antifungal therapy in this retrospective study. All patients, who were older than 14 years of age and developed at least one neutropenic episode after chemotherapy due to hematological cancer from November 2010 to November 2012, were included into the study. We retrospectively collected demographic, treatment, and survival data of 126 patients with neutropenia and their 282 febrile episodes. The mean Multinational Association for Supportive Care in Cancer score was 17.18 ± 8.27. Systemic antifungal drugs were initiated in 22 patients with 30 culture-proven invasive fungal infections (IFIs), 25 attacks of 19 patients with probable invasive pulmonary aspergillosis (IPA), 42 attacks of 38 patients with possible IPA, and 31 attacks of 30 patients with suspected IFI. Voriconazole (VOR), caspofungin and liposomal amphotericin B were used to treat 72 episodes of 65 patients, 45 episodes of 37 patients and 34 episodes of 32 patients as a first-line therapy, respectively. Unfavorable conditions of our hematology ward are thought to increase the number of cases with invasive pulmonary aspergillosis and VOR use. It should be taken into consideration that increased systemic and per oral VOR usage predisposes patients to colonization and infection with azole-resistant fungal strains. Catheters should be removed in cases where patients' conditions are convenient to remove it. Acute myeloblastic leukemia cases that are more likely to develop invasive fungal infections should be monitored closely for early diagnosis and timely initiation of antifungal drugs which directly correlates with survival rates.

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Section: Discussionmentioning

confidence: 54%

Novel Antifungal Drugs Against Fungal Pathogens: Do They Provide Promising Results for Treatment?

Gedık

Şimşek

Yıldırmak

et al. 2014

Indian J Hematol Blood Transfus

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“…12 Another case-control study found that case-patients receiving adequate treatment for IC had increased length-of-stay (LOS) by 3 to 13 days, as well as $3,000 to $22,000 more in hospital costs compared to controls. 13 This same study found that patients were more likely to die when inadequate candidemia treatment was administered.…”

Section: The Case For Antifungal Stewardshipmentioning

confidence: 88%

Antifungal stewardship considerations for adults and pediatrics

2016

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Antifungal stewardship refers to coordinated interventions to monitor and direct the appropriate use of antifungal agents in order to achieve the best clinical outcomes and minimize selective pressure and adverse events. Antifungal utilization has steadily risen over time in concert with the increase in number of immunocompromised adults and children at risk for invasive fungal infections (IFI). Challenges in diagnosing IFI often lead to delays in treatment and poorer outcomes. There are also emerging data linking prior antifungal exposure and suboptimal dosing to the emergence of antifungal resistance, particularly for Candida. Antimicrobial stewardship programs can take a multi-pronged bundle approach to ensure suitable prescribing of antifungals via postprescription review and feedback and/or prior authorization. Institutional guidelines can also be developed to guide diagnostic testing in at-risk populations; appropriate choice, dose, and duration of antifungal agent; therapeutic drug monitoring; and opportunities for de-escalation and intravenous-to-oral conversion.

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“…La mortalidad atribuible a bacteriemias por Acinetobacter baumannii multiresistente en el estudio de NY Lee fue de 21,8% 6 . La mortalidad atribuible a candidemias fue de 24% 9 . Los estudios realizados en neumonía asociada a ventilación mecánica (NAVM), documentaron una mortalidad atribuible variable, de 16% 10 y 7,3% 11 .…”

Section: Discussionunclassified

Impacto de la infección nosocomial en un hospital de Bogotá (Colombia): efectos en mortalidad y costos

Trujillo

Ordóñez

Díaz

2015

Rev. chil. infectol.

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Excess Mortality, Hospital Stay, and Cost Due to Candidemia: A Case-Control Study Using Data From Population-Based Candidemia Surveillance

Abstract: Our findings underscore the burden of candidemia, particularly regarding the risk of death, length of hospitalization, and cost associated with treatment.

Cited by 385 publications

References 27 publications

Novel Antifungal Drugs Against Fungal Pathogens: Do They Provide Promising Results for Treatment?

Novel Antifungal Drugs Against Fungal Pathogens: Do They Provide Promising Results for Treatment?

Antifungal stewardship considerations for adults and pediatrics

Impacto de la infección nosocomial en un hospital de Bogotá (Colombia): efectos en mortalidad y costos

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