Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2019 Jun 14;23(1):219.
doi: 10.1186/s13054-019-2497-3.

Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

Matteo Bassetti  1   2 , Daniele R Giacobbe  3 , Antonio Vena  4 , Cecilia Trucchi  5   6 , Filippo Ansaldi  3   5   6 , Massimo Antonelli  7 , Vaclava Adamkova  8   9 , Cristiano Alicino  3   10 , Maria-Panagiota Almyroudi  11 , Enora Atchade  12 , Anna M Azzini  13 , Novella Carannante  14 , Alessia Carnelutti  4 , Silvia Corcione  15 , Andrea Cortegiani  16 , George Dimopoulos  11 , Simon Dubler  17 , José L García-Garmendia  18 , Massimo Girardis  19 , Oliver A Cornely  20 , Stefano Ianniruberto  21 , Bart Jan Kullberg  22 , Katrien Lagrou  23   24 , Clement Le Bihan  25 , Roberto Luzzati  26 , Manu L N G Malbrain  27 , Maria Merelli  4 , Ana J Marques  28 , Ignacio Martin-Loeches  29   30 , Alessio Mesini  3 , José-Artur Paiva  31 , Maddalena Peghin  4 , Santi Maurizio Raineri  32 , Riina Rautemaa-Richardson  33 , Jeroen Schouten  22 , Pierluigi Brugnaro  34 , Herbert Spapen  35 , Polychronis Tasioudis  36 , Jean-François Timsit  37   38 , Valentino Tisa  3 , Mario Tumbarello  39 , Charlotte H S B van den Berg  40 , Benoit Veber  41 , Mario Venditti  42 , Guillaume Voiriot  43 , Joost Wauters  44 , Philippe Montravers  12   45
Affiliations
Multicenter Study

Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

Matteo Bassetti et al. Crit Care. .

Abstract

Background: The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe.

Methods: A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU).

Results: During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candidemia and IAC were 5.52 and 1.84 episodes per 1000 ICU admissions, respectively. Crude 30-day mortality was 42%. Age (odds ratio [OR] 1.04 per year, 95% CI 1.02-1.06, p < 0.001), severe hepatic failure (OR 3.25, 95% 1.31-8.08, p 0.011), SOFA score at the onset of IC (OR 1.11 per point, 95% CI 1.04-1.17, p 0.001), and septic shock (OR 2.12, 95% CI 1.24-3.63, p 0.006) were associated with increased 30-day mortality in a secondary, exploratory analysis.

Conclusions: The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions. Future in-depth analyses will allow explaining part of the observed between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions.

Keywords: Abdominal candidiasis; Candida; Candidemia; Candidiasis; ICU; Incidence.

PubMed Disclaimer

Conflict of interest statement

Outside the submitted work, MB reports grants and personal fees from Pfizer, grants and personal fees from MSD, grants and personal fees from Cidara, personal fees from Astellas, and personal fees from Gilead. DRG reports personal fees from Stepstone Pharma GmbH and an unconditioned grant from MSD Italia. GD reports personal fees from Pfizer, Infectopharm, and EU/FP7/Magic Bullet and a grant for his institution from MSD. JLGG reports a formative grant from MSD, a formative grant from Fresenius, and payment for lecture from Astra Zeneca. BJK reports grants for his institution from Amplyx, Astellas, and Cidara. KL has received research grants from Gilead, MSD, and Pfizer; consultancy fees from Gilead, Pfizer, Abbott, MSD, and SMB Laboratoires Brussels; travel support from Pfizer, Gilead, and MSD; and speaker fees from Gilead, Roche, and Abbott. JFT has received grants for his institution from Pfizer and MSD and personal fees from BioMérieux and participated in advisory board for MSD, Bayer, 3 M, and Gilead. PM reports personal fees from Pfizer and MSD. The other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Cumulative incidence of ICU-acquired invasive candidiasis. IAC, intra-abdominal candidiasis; IC, invasive candidiasis; ICU, intensive care unit
See this image and copyright information in PMC

References

    1. Bassetti M, Righi E, Ansaldi F, Merelli M, Scarparo C, Antonelli M, et al. A multicenter multinational study of abdominal candidiasis: epidemiology, outcomes and predictors of mortality. Intensive Care Med. 2015;41:1601–1610. doi: 10.1007/s00134-015-3866-2. - DOI - PubMed
    1. Bassetti M, Righi E, Ansaldi F, Merelli M, Trucchi C, De Pascale G, et al. A multicenter study of septic shock due to candidemia: outcomes and predictors of mortality. Intensive Care Med. 2014;40:839–845. doi: 10.1007/s00134-014-3310-z. - DOI - PubMed
    1. Bouza E, Munoz P. Epidemiology of candidemia in intensive care units. Int J Antimicrob Agents. 2008;32(Suppl 2):S87–S91. doi: 10.1016/S0924-8579(08)70006-2. - DOI - PubMed
    1. Leroy O, Bailly S, Gangneux JP, Mira JP, Devos P, Dupont H, et al. Systemic antifungal therapy for proven or suspected invasive candidiasis: the AmarCAND 2 study. Ann Intensive Care. 2016;6:2. doi: 10.1186/s13613-015-0103-7. - DOI - PMC - PubMed
    1. Guery BP, Arendrup MC, Auzinger G, Azoulay E, Borges Sá M, Johnson EM, et al. Management of invasive candidiasis and candidaemia in adult non-neutropenic intensive care unit patients. Part I. epidemiology and diagnosis. Intensive Care Med. 2009;35:55–62. doi: 10.1007/s00134-008-1338-7. - DOI - PubMed

Publication types

MeSH terms