High incidence of candidaemia in a nationwide cohort: Underlying diseases, risk factors and mortality

K. R. Lausch*, M. Søgaard, F. S. Rosenvinge, H. K. Johansen, T. Boysen, B. Røder, K. L. Mortensen, L. Nielsen, L. Lemming, B. Olesen, C. Leitz, L. Kristensen, E. Dzajic, L. Østergaard, H. C. Schønheyder, M. C. Arendrup

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Resumé

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.

OriginalsprogEngelsk
TidsskriftInternational Journal of Infectious Diseases
Vol/bind76
Sider (fra-til)58-63
ISSN1201-9712
DOI
StatusUdgivet - 1. nov. 2018

Fingeraftryk

Candidemia
Incidence
Denmark
Intensive Care Units
Hematologic Diseases
Gastrointestinal Diseases
Hematologic Neoplasms
Confidence Intervals
Population

Citer dette

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. / High incidence of candidaemia in a nationwide cohort : Underlying diseases, risk factors and mortality. I: International Journal of Infectious Diseases. 2018 ; Bind 76. s. 58-63.
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title = "High incidence of candidaemia in a nationwide cohort: Underlying diseases, risk factors and mortality",
abstract = "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.",
keywords = "Candida, Candidaemia, Epidemiology, Mortality, Outcome",
author = "Lausch, {K. R.} and M. S{\o}gaard and Rosenvinge, {F. S.} and Johansen, {H. K.} and T. Boysen and B. R{\o}der and Mortensen, {K. L.} and L. Nielsen and L. Lemming and B. Olesen and C. Leitz and L. Kristensen and E. Dzajic and L. {\O}stergaard and Sch{\o}nheyder, {H. C.} and Arendrup, {M. C.}",
year = "2018",
month = "11",
day = "1",
doi = "10.1016/j.ijid.2018.08.010",
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Lausch, KR, Søgaard, M, Rosenvinge, FS, Johansen, HK, Boysen, T, Røder, B, Mortensen, KL, Nielsen, L, Lemming, L, Olesen, B, Leitz, C, Kristensen, L, Dzajic, E, Østergaard, L, Schønheyder, HC & Arendrup, MC 2018, 'High incidence of candidaemia in a nationwide cohort: Underlying diseases, risk factors and mortality', International Journal of Infectious Diseases, bind 76, s. 58-63. https://doi.org/10.1016/j.ijid.2018.08.010

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.

I: International Journal of Infectious Diseases, Bind 76, 01.11.2018, s. 58-63.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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 - 2018/11/1

Y1 - 2018/11/1

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 -