Candidemia in solid organ transplant recipients in Spain: Epidemiological trends and determinants of outcome
Background Despite being considered a high‐risk population for invasive fungal disease, specific features of candidemia among solid organ transplant (SOT) recipients remain poorly characterized. Methods We compiled prospective data from two multicenter studies on candidemia performed over two consec...
Gespeichert in:
| Veröffentlicht in: | Transplant infectious disease 2019-12, Vol.21 (6), p.e13195-n/a |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | n/a |
|---|---|
| container_issue | 6 |
| container_start_page | e13195 |
| container_title | Transplant infectious disease |
| container_volume | 21 |
| creator | Fernández‐Ruiz, Mario Cardozo, Celia Salavert, Miguel Aguilar‐Guisado, Manuela Escolà‐Vergé, Laura Gioia, Francesca Montejo, Miguel Merino, Paloma Cuervo, Guillermo García‐Vidal, Carolina Aguado, José María Padilla, B Paño‐Pardo, J. R. García‐Rodríguez, J García Cerrada, C. Fortún, J Martín‐Dávila, P. Gómez‐García de la Pedrosa, E Ryan, P. Campelo, C. de los Santos Gil, I. Buendía, V. Pérez Gorricho, B. Alonso, M. Sanz Sanz, F. González Romo, F. Gorgolas, M. Gadea, I. Delgado‐Iribarren, A. Ramos, A. Sánchez Romero, I. Zaragoza, Ó. Cuenca‐Estrella, M. Rodríguez‐Baño, J. Suárez, A. I. Loza, A. Martín‐Mazuelos, E. Ruiz Pérez de Pipaón, M. Garnacho, J. Ortiz, C Chávez, M. Maroto, F. L. Pemán, J. Blanquer, J. Navarro, D. Camarena, J. J. Zaragoza, R Abril, V. Gimeno, C. Hernández, S. Ezpeleta, G. Bereciartua, E. Hernández Almaraz, J. L. Rivas, R. A. Ayarza, R. Planes, A. M. Ruiz‐Camps, I. Almirante, B. Mensa, J. Almela, M. Gurgui, M. Sánchez‐Reus, F. Martínez‐Montauti, J. Sierra, M. Horcajada, J. P. Sorli, L. Gómez, J. Gené, A. Urrea, M. Valerio, M. Díaz‐Martín, A. Puchades, F. Mularoni, A. Puerta‐Alcalde, P. Morata, L. Rodríguez‐Núñez, O. Guerrero, M. A. Carratalà, J. Sabé, N. Ayats, J. Grau, I. Calabuig, E. Castro, I. Cuéllar, S. Fortún, J. Martín‐Dávila, P. Gómez‐García de la Pedrosa, E. Pérez‐Ayala, A. Losada, I. Navarro, D. Suarez, M. I. Martín‐Gómez, M. T. Almirante, B. Rodríguez‐Alvarez, R. López‐Soira, L. Vena, A. Valerio, M. Bouza, E. Guinea, J. Martín, C. |
| description | Background
Despite being considered a high‐risk population for invasive fungal disease, specific features of candidemia among solid organ transplant (SOT) recipients remain poorly characterized.
Methods
We compiled prospective data from two multicenter studies on candidemia performed over two consecutive periods in Spain: the CANDIPOP Study (2010‐2011) and the CANDI‐Bundle Study (2016‐2018). Episodes diagnosed in adult SOT recipients in 10 participating centers were included. Risk factors for clinical failure (all‐cause 7‐day mortality and/or persistent candidemia for ≥72 hours) and 30‐day mortality were investigated by univariate analysis.
Results
We included 55 episodes of post‐transplant candidemia (32 and 23 of which occurred during the first and second periods). Kidney (38.2%) and liver recipients (30.9%) were the most common populations. Candida albicans accounted for 27.3% of episodes. The proportion of C glabrata increased over time (18.8% vs 30.4% for the first and second periods). There were no differences in the rate of fluconazole non‐susceptible isolates (50.0% vs 60.0%, respectively). Clinical failure and 30‐day mortality occurred in 25.5% and 27.3% of episodes and were associated with the severity of candidemia (Pitt score and severe sepsis/septic shock). Kidney transplantation (unadjusted odds ratio [uOR]: 0.17; 95% confidence interval [CI]: 0.03‐0.85; P‐value = .020), early catheter removal (uOR: 0.15; 95% CI: 0.03‐0.76; P‐value = .013), and appropriate early antifungal therapy (uOR: 0.14; 95% CI: 0.02‐0.89; P‐value = .041) were protective for 30‐day mortality.
Conclusions
High rates of non‐albicans species and fluconazole non‐susceptibility must be taken into account to optimize therapeutic management and outcomes in SOT recipients with candidemia. |
| doi_str_mv | 10.1111/tid.13195 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2305802027</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2326813553</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3535-be2ac400e29ec8a370b68497f5fa276de242d8e7ae4b87f0a6d117f64609edb13</originalsourceid><addsrcrecordid>eNp1kU1LxDAQhoMofqwe_AMS8KKHuvlom9abrOsHLHhQzyFtphJpk5q0yP57s1v1IJjL5PDMw8y8CJ1SckXjmw9GX1FOy2wHHVJelgknOdvd_ouEMcEP0FEI74RQUablPjrgNKeECHGI2oWy2mjojMLG4uBao7Hzb8riwSsb-lbZAXuoTW_ADmEDPffK2Gu87Ld9rnVvplZt5MHqgKMPaxjAd8aqTYdrsBuH2nVwjPYa1QY4-a4z9Hq3fFk8JKun-8fFzSqpecazpAKm6pQQYCXUheKCVHmRlqLJGsVEroGlTBcgFKRVIRqick2paPI0JyXoivIZupi8vXcfI4RBdibU0MZdwI1BMk6ygjASLzND53_Qdzd6G6eLFMsLyrOMR-pyomrvQvDQyN6bTvm1pERuIpAxArmNILJn38ax6kD_kj83j8B8Aj5NC-v_TfLl8XZSfgFr7ZDF</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2326813553</pqid></control><display><type>article</type><title>Candidemia in solid organ transplant recipients in Spain: Epidemiological trends and determinants of outcome</title><source>MEDLINE</source><source>Wiley-Blackwell Full Collection</source><creator>Fernández‐Ruiz, Mario ; Cardozo, Celia ; Salavert, Miguel ; Aguilar‐Guisado, Manuela ; Escolà‐Vergé, Laura ; Gioia, Francesca ; Montejo, Miguel ; Merino, Paloma ; Cuervo, Guillermo ; García‐Vidal, Carolina ; Aguado, José María ; Padilla, B ; Paño‐Pardo, J. R. ; García‐Rodríguez, J ; García Cerrada, C. ; Fortún, J ; Martín‐Dávila, P. ; Gómez‐García de la Pedrosa, E ; Ryan, P. ; Campelo, C. ; de los Santos Gil, I. ; Buendía, V. ; Pérez Gorricho, B. ; Alonso, M. ; Sanz Sanz, F. ; González Romo, F. ; Gorgolas, M. ; Gadea, I. ; Delgado‐Iribarren, A. ; Ramos, A. ; Sánchez Romero, I. ; Zaragoza, Ó. ; Cuenca‐Estrella, M. ; Rodríguez‐Baño, J. ; Suárez, A. I. ; Loza, A. ; Martín‐Mazuelos, E. ; Ruiz Pérez de Pipaón, M. ; Garnacho, J. ; Ortiz, C ; Chávez, M. ; Maroto, F. L. ; Pemán, J. ; Blanquer, J. ; Navarro, D. ; Camarena, J. J. ; Zaragoza, R ; Abril, V. ; Gimeno, C. ; Hernández, S. ; Ezpeleta, G. ; Bereciartua, E. ; Hernández Almaraz, J. L. ; Rivas, R. A. ; Ayarza, R. ; Planes, A. M. ; Ruiz‐Camps, I. ; Almirante, B. ; Mensa, J. ; Almela, M. ; Gurgui, M. ; Sánchez‐Reus, F. ; Martínez‐Montauti, J. ; Sierra, M. ; Horcajada, J. P. ; Sorli, L. ; Gómez, J. ; Gené, A. ; Urrea, M. ; Valerio, M. ; Díaz‐Martín, A. ; Puchades, F. ; Mularoni, A. ; Puerta‐Alcalde, P. ; Morata, L. ; Rodríguez‐Núñez, O. ; Guerrero, M. A. ; Carratalà, J. ; Sabé, N. ; Ayats, J. ; Grau, I. ; Calabuig, E. ; Castro, I. ; Cuéllar, S. ; Fortún, J. ; Martín‐Dávila, P. ; Gómez‐García de la Pedrosa, E. ; Pérez‐Ayala, A. ; Losada, I. ; Navarro, D. ; Suarez, M. I. ; Martín‐Gómez, M. T. ; Almirante, B. ; Rodríguez‐Alvarez, R. ; López‐Soira, L. ; Vena, A. ; Valerio, M. ; Bouza, E. ; Guinea, J. ; Martín, C.</creator><creatorcontrib>Fernández‐Ruiz, Mario ; Cardozo, Celia ; Salavert, Miguel ; Aguilar‐Guisado, Manuela ; Escolà‐Vergé, Laura ; Gioia, Francesca ; Montejo, Miguel ; Merino, Paloma ; Cuervo, Guillermo ; García‐Vidal, Carolina ; Aguado, José María ; Padilla, B ; Paño‐Pardo, J. R. ; García‐Rodríguez, J ; García Cerrada, C. ; Fortún, J ; Martín‐Dávila, P. ; Gómez‐García de la Pedrosa, E ; Ryan, P. ; Campelo, C. ; de los Santos Gil, I. ; Buendía, V. ; Pérez Gorricho, B. ; Alonso, M. ; Sanz Sanz, F. ; González Romo, F. ; Gorgolas, M. ; Gadea, I. ; Delgado‐Iribarren, A. ; Ramos, A. ; Sánchez Romero, I. ; Zaragoza, Ó. ; Cuenca‐Estrella, M. ; Rodríguez‐Baño, J. ; Suárez, A. I. ; Loza, A. ; Martín‐Mazuelos, E. ; Ruiz Pérez de Pipaón, M. ; Garnacho, J. ; Ortiz, C ; Chávez, M. ; Maroto, F. L. ; Pemán, J. ; Blanquer, J. ; Navarro, D. ; Camarena, J. J. ; Zaragoza, R ; Abril, V. ; Gimeno, C. ; Hernández, S. ; Ezpeleta, G. ; Bereciartua, E. ; Hernández Almaraz, J. L. ; Rivas, R. A. ; Ayarza, R. ; Planes, A. M. ; Ruiz‐Camps, I. ; Almirante, B. ; Mensa, J. ; Almela, M. ; Gurgui, M. ; Sánchez‐Reus, F. ; Martínez‐Montauti, J. ; Sierra, M. ; Horcajada, J. P. ; Sorli, L. ; Gómez, J. ; Gené, A. ; Urrea, M. ; Valerio, M. ; Díaz‐Martín, A. ; Puchades, F. ; Mularoni, A. ; Puerta‐Alcalde, P. ; Morata, L. ; Rodríguez‐Núñez, O. ; Guerrero, M. A. ; Carratalà, J. ; Sabé, N. ; Ayats, J. ; Grau, I. ; Calabuig, E. ; Castro, I. ; Cuéllar, S. ; Fortún, J. ; Martín‐Dávila, P. ; Gómez‐García de la Pedrosa, E. ; Pérez‐Ayala, A. ; Losada, I. ; Navarro, D. ; Suarez, M. I. ; Martín‐Gómez, M. T. ; Almirante, B. ; Rodríguez‐Alvarez, R. ; López‐Soira, L. ; Vena, A. ; Valerio, M. ; Bouza, E. ; Guinea, J. ; Martín, C. ; CANDIPOP Project, the CANDI-Bundle Group ; GEIRAS-GEMICOMED (SEIMC)REIPI ; on behalf of the CANDIPOP Project, the CANDI‐Bundle Group ; GEIRAS‐GEMICOMED (SEIMC)REIPI</creatorcontrib><description>Background
Despite being considered a high‐risk population for invasive fungal disease, specific features of candidemia among solid organ transplant (SOT) recipients remain poorly characterized.
Methods
We compiled prospective data from two multicenter studies on candidemia performed over two consecutive periods in Spain: the CANDIPOP Study (2010‐2011) and the CANDI‐Bundle Study (2016‐2018). Episodes diagnosed in adult SOT recipients in 10 participating centers were included. Risk factors for clinical failure (all‐cause 7‐day mortality and/or persistent candidemia for ≥72 hours) and 30‐day mortality were investigated by univariate analysis.
Results
We included 55 episodes of post‐transplant candidemia (32 and 23 of which occurred during the first and second periods). Kidney (38.2%) and liver recipients (30.9%) were the most common populations. Candida albicans accounted for 27.3% of episodes. The proportion of C glabrata increased over time (18.8% vs 30.4% for the first and second periods). There were no differences in the rate of fluconazole non‐susceptible isolates (50.0% vs 60.0%, respectively). Clinical failure and 30‐day mortality occurred in 25.5% and 27.3% of episodes and were associated with the severity of candidemia (Pitt score and severe sepsis/septic shock). Kidney transplantation (unadjusted odds ratio [uOR]: 0.17; 95% confidence interval [CI]: 0.03‐0.85; P‐value = .020), early catheter removal (uOR: 0.15; 95% CI: 0.03‐0.76; P‐value = .013), and appropriate early antifungal therapy (uOR: 0.14; 95% CI: 0.02‐0.89; P‐value = .041) were protective for 30‐day mortality.
Conclusions
High rates of non‐albicans species and fluconazole non‐susceptibility must be taken into account to optimize therapeutic management and outcomes in SOT recipients with candidemia.</description><identifier>ISSN: 1398-2273</identifier><identifier>EISSN: 1399-3062</identifier><identifier>DOI: 10.1111/tid.13195</identifier><identifier>PMID: 31610077</identifier><language>eng</language><publisher>Denmark: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aged ; Antifungal Agents - pharmacology ; Antifungal Agents - therapeutic use ; Candida albicans - drug effects ; Candida albicans - isolation & purification ; Candida glabrata - drug effects ; Candida glabrata - isolation & purification ; Candidemia ; Candidemia - drug therapy ; Candidemia - epidemiology ; Candidemia - microbiology ; Confidence intervals ; Drug Resistance, Fungal ; Epidemiology ; Female ; Fluconazole ; Fluconazole - pharmacology ; Fluconazole - therapeutic use ; Fungal diseases ; Fungicides ; Hospital Mortality ; Humans ; Kidney transplantation ; Male ; Medical instruments ; Microbial Sensitivity Tests ; Middle Aged ; Mortality ; Multicenter Studies as Topic ; Organ Transplantation - adverse effects ; outcome ; Prospective Studies ; Risk analysis ; Risk Factors ; Sepsis ; Septic shock ; solid organ transplantation ; Spain - epidemiology ; Transplant Recipients - statistics & numerical data ; Transplants & implants ; treatment</subject><ispartof>Transplant infectious disease, 2019-12, Vol.21 (6), p.e13195-n/a</ispartof><rights>2019 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3535-be2ac400e29ec8a370b68497f5fa276de242d8e7ae4b87f0a6d117f64609edb13</citedby><cites>FETCH-LOGICAL-c3535-be2ac400e29ec8a370b68497f5fa276de242d8e7ae4b87f0a6d117f64609edb13</cites><orcidid>0000-0002-5608-3090 ; 0000-0002-0315-8001 ; 0000-0002-0697-3992</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftid.13195$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftid.13195$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31610077$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fernández‐Ruiz, Mario</creatorcontrib><creatorcontrib>Cardozo, Celia</creatorcontrib><creatorcontrib>Salavert, Miguel</creatorcontrib><creatorcontrib>Aguilar‐Guisado, Manuela</creatorcontrib><creatorcontrib>Escolà‐Vergé, Laura</creatorcontrib><creatorcontrib>Gioia, Francesca</creatorcontrib><creatorcontrib>Montejo, Miguel</creatorcontrib><creatorcontrib>Merino, Paloma</creatorcontrib><creatorcontrib>Cuervo, Guillermo</creatorcontrib><creatorcontrib>García‐Vidal, Carolina</creatorcontrib><creatorcontrib>Aguado, José María</creatorcontrib><creatorcontrib>Padilla, B</creatorcontrib><creatorcontrib>Paño‐Pardo, J. R.</creatorcontrib><creatorcontrib>García‐Rodríguez, J</creatorcontrib><creatorcontrib>García Cerrada, C.</creatorcontrib><creatorcontrib>Fortún, J</creatorcontrib><creatorcontrib>Martín‐Dávila, P.</creatorcontrib><creatorcontrib>Gómez‐García de la Pedrosa, E</creatorcontrib><creatorcontrib>Ryan, P.</creatorcontrib><creatorcontrib>Campelo, C.</creatorcontrib><creatorcontrib>de los Santos Gil, I.</creatorcontrib><creatorcontrib>Buendía, V.</creatorcontrib><creatorcontrib>Pérez Gorricho, B.</creatorcontrib><creatorcontrib>Alonso, M.</creatorcontrib><creatorcontrib>Sanz Sanz, F.</creatorcontrib><creatorcontrib>González Romo, F.</creatorcontrib><creatorcontrib>Gorgolas, M.</creatorcontrib><creatorcontrib>Gadea, I.</creatorcontrib><creatorcontrib>Delgado‐Iribarren, A.</creatorcontrib><creatorcontrib>Ramos, A.</creatorcontrib><creatorcontrib>Sánchez Romero, I.</creatorcontrib><creatorcontrib>Zaragoza, Ó.</creatorcontrib><creatorcontrib>Cuenca‐Estrella, M.</creatorcontrib><creatorcontrib>Rodríguez‐Baño, J.</creatorcontrib><creatorcontrib>Suárez, A. I.</creatorcontrib><creatorcontrib>Loza, A.</creatorcontrib><creatorcontrib>Martín‐Mazuelos, E.</creatorcontrib><creatorcontrib>Ruiz Pérez de Pipaón, M.</creatorcontrib><creatorcontrib>Garnacho, J.</creatorcontrib><creatorcontrib>Ortiz, C</creatorcontrib><creatorcontrib>Chávez, M.</creatorcontrib><creatorcontrib>Maroto, F. L.</creatorcontrib><creatorcontrib>Pemán, J.</creatorcontrib><creatorcontrib>Blanquer, J.</creatorcontrib><creatorcontrib>Navarro, D.</creatorcontrib><creatorcontrib>Camarena, J. J.</creatorcontrib><creatorcontrib>Zaragoza, R</creatorcontrib><creatorcontrib>Abril, V.</creatorcontrib><creatorcontrib>Gimeno, C.</creatorcontrib><creatorcontrib>Hernández, S.</creatorcontrib><creatorcontrib>Ezpeleta, G.</creatorcontrib><creatorcontrib>Bereciartua, E.</creatorcontrib><creatorcontrib>Hernández Almaraz, J. L.</creatorcontrib><creatorcontrib>Rivas, R. A.</creatorcontrib><creatorcontrib>Ayarza, R.</creatorcontrib><creatorcontrib>Planes, A. M.</creatorcontrib><creatorcontrib>Ruiz‐Camps, I.</creatorcontrib><creatorcontrib>Almirante, B.</creatorcontrib><creatorcontrib>Mensa, J.</creatorcontrib><creatorcontrib>Almela, M.</creatorcontrib><creatorcontrib>Gurgui, M.</creatorcontrib><creatorcontrib>Sánchez‐Reus, F.</creatorcontrib><creatorcontrib>Martínez‐Montauti, J.</creatorcontrib><creatorcontrib>Sierra, M.</creatorcontrib><creatorcontrib>Horcajada, J. P.</creatorcontrib><creatorcontrib>Sorli, L.</creatorcontrib><creatorcontrib>Gómez, J.</creatorcontrib><creatorcontrib>Gené, A.</creatorcontrib><creatorcontrib>Urrea, M.</creatorcontrib><creatorcontrib>Valerio, M.</creatorcontrib><creatorcontrib>Díaz‐Martín, A.</creatorcontrib><creatorcontrib>Puchades, F.</creatorcontrib><creatorcontrib>Mularoni, A.</creatorcontrib><creatorcontrib>Puerta‐Alcalde, P.</creatorcontrib><creatorcontrib>Morata, L.</creatorcontrib><creatorcontrib>Rodríguez‐Núñez, O.</creatorcontrib><creatorcontrib>Guerrero, M. A.</creatorcontrib><creatorcontrib>Carratalà, J.</creatorcontrib><creatorcontrib>Sabé, N.</creatorcontrib><creatorcontrib>Ayats, J.</creatorcontrib><creatorcontrib>Grau, I.</creatorcontrib><creatorcontrib>Calabuig, E.</creatorcontrib><creatorcontrib>Castro, I.</creatorcontrib><creatorcontrib>Cuéllar, S.</creatorcontrib><creatorcontrib>Fortún, J.</creatorcontrib><creatorcontrib>Martín‐Dávila, P.</creatorcontrib><creatorcontrib>Gómez‐García de la Pedrosa, E.</creatorcontrib><creatorcontrib>Pérez‐Ayala, A.</creatorcontrib><creatorcontrib>Losada, I.</creatorcontrib><creatorcontrib>Navarro, D.</creatorcontrib><creatorcontrib>Suarez, M. I.</creatorcontrib><creatorcontrib>Martín‐Gómez, M. T.</creatorcontrib><creatorcontrib>Almirante, B.</creatorcontrib><creatorcontrib>Rodríguez‐Alvarez, R.</creatorcontrib><creatorcontrib>López‐Soira, L.</creatorcontrib><creatorcontrib>Vena, A.</creatorcontrib><creatorcontrib>Valerio, M.</creatorcontrib><creatorcontrib>Bouza, E.</creatorcontrib><creatorcontrib>Guinea, J.</creatorcontrib><creatorcontrib>Martín, C.</creatorcontrib><creatorcontrib>CANDIPOP Project, the CANDI-Bundle Group</creatorcontrib><creatorcontrib>GEIRAS-GEMICOMED (SEIMC)REIPI</creatorcontrib><creatorcontrib>on behalf of the CANDIPOP Project, the CANDI‐Bundle Group</creatorcontrib><creatorcontrib>GEIRAS‐GEMICOMED (SEIMC)REIPI</creatorcontrib><title>Candidemia in solid organ transplant recipients in Spain: Epidemiological trends and determinants of outcome</title><title>Transplant infectious disease</title><addtitle>Transpl Infect Dis</addtitle><description>Background
Despite being considered a high‐risk population for invasive fungal disease, specific features of candidemia among solid organ transplant (SOT) recipients remain poorly characterized.
Methods
We compiled prospective data from two multicenter studies on candidemia performed over two consecutive periods in Spain: the CANDIPOP Study (2010‐2011) and the CANDI‐Bundle Study (2016‐2018). Episodes diagnosed in adult SOT recipients in 10 participating centers were included. Risk factors for clinical failure (all‐cause 7‐day mortality and/or persistent candidemia for ≥72 hours) and 30‐day mortality were investigated by univariate analysis.
Results
We included 55 episodes of post‐transplant candidemia (32 and 23 of which occurred during the first and second periods). Kidney (38.2%) and liver recipients (30.9%) were the most common populations. Candida albicans accounted for 27.3% of episodes. The proportion of C glabrata increased over time (18.8% vs 30.4% for the first and second periods). There were no differences in the rate of fluconazole non‐susceptible isolates (50.0% vs 60.0%, respectively). Clinical failure and 30‐day mortality occurred in 25.5% and 27.3% of episodes and were associated with the severity of candidemia (Pitt score and severe sepsis/septic shock). Kidney transplantation (unadjusted odds ratio [uOR]: 0.17; 95% confidence interval [CI]: 0.03‐0.85; P‐value = .020), early catheter removal (uOR: 0.15; 95% CI: 0.03‐0.76; P‐value = .013), and appropriate early antifungal therapy (uOR: 0.14; 95% CI: 0.02‐0.89; P‐value = .041) were protective for 30‐day mortality.
Conclusions
High rates of non‐albicans species and fluconazole non‐susceptibility must be taken into account to optimize therapeutic management and outcomes in SOT recipients with candidemia.</description><subject>Adult</subject><subject>Aged</subject><subject>Antifungal Agents - pharmacology</subject><subject>Antifungal Agents - therapeutic use</subject><subject>Candida albicans - drug effects</subject><subject>Candida albicans - isolation & purification</subject><subject>Candida glabrata - drug effects</subject><subject>Candida glabrata - isolation & purification</subject><subject>Candidemia</subject><subject>Candidemia - drug therapy</subject><subject>Candidemia - epidemiology</subject><subject>Candidemia - microbiology</subject><subject>Confidence intervals</subject><subject>Drug Resistance, Fungal</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Fluconazole</subject><subject>Fluconazole - pharmacology</subject><subject>Fluconazole - therapeutic use</subject><subject>Fungal diseases</subject><subject>Fungicides</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Kidney transplantation</subject><subject>Male</subject><subject>Medical instruments</subject><subject>Microbial Sensitivity Tests</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multicenter Studies as Topic</subject><subject>Organ Transplantation - adverse effects</subject><subject>outcome</subject><subject>Prospective Studies</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Sepsis</subject><subject>Septic shock</subject><subject>solid organ transplantation</subject><subject>Spain - epidemiology</subject><subject>Transplant Recipients - statistics & numerical data</subject><subject>Transplants & implants</subject><subject>treatment</subject><issn>1398-2273</issn><issn>1399-3062</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1LxDAQhoMofqwe_AMS8KKHuvlom9abrOsHLHhQzyFtphJpk5q0yP57s1v1IJjL5PDMw8y8CJ1SckXjmw9GX1FOy2wHHVJelgknOdvd_ouEMcEP0FEI74RQUablPjrgNKeECHGI2oWy2mjojMLG4uBao7Hzb8riwSsb-lbZAXuoTW_ADmEDPffK2Gu87Ld9rnVvplZt5MHqgKMPaxjAd8aqTYdrsBuH2nVwjPYa1QY4-a4z9Hq3fFk8JKun-8fFzSqpecazpAKm6pQQYCXUheKCVHmRlqLJGsVEroGlTBcgFKRVIRqick2paPI0JyXoivIZupi8vXcfI4RBdibU0MZdwI1BMk6ygjASLzND53_Qdzd6G6eLFMsLyrOMR-pyomrvQvDQyN6bTvm1pERuIpAxArmNILJn38ax6kD_kj83j8B8Aj5NC-v_TfLl8XZSfgFr7ZDF</recordid><startdate>201912</startdate><enddate>201912</enddate><creator>Fernández‐Ruiz, Mario</creator><creator>Cardozo, Celia</creator><creator>Salavert, Miguel</creator><creator>Aguilar‐Guisado, Manuela</creator><creator>Escolà‐Vergé, Laura</creator><creator>Gioia, Francesca</creator><creator>Montejo, Miguel</creator><creator>Merino, Paloma</creator><creator>Cuervo, Guillermo</creator><creator>García‐Vidal, Carolina</creator><creator>Aguado, José María</creator><creator>Padilla, B</creator><creator>Paño‐Pardo, J. R.</creator><creator>García‐Rodríguez, J</creator><creator>García Cerrada, C.</creator><creator>Fortún, J</creator><creator>Martín‐Dávila, P.</creator><creator>Gómez‐García de la Pedrosa, E</creator><creator>Ryan, P.</creator><creator>Campelo, C.</creator><creator>de los Santos Gil, I.</creator><creator>Buendía, V.</creator><creator>Pérez Gorricho, B.</creator><creator>Alonso, M.</creator><creator>Sanz Sanz, F.</creator><creator>González Romo, F.</creator><creator>Gorgolas, M.</creator><creator>Gadea, I.</creator><creator>Delgado‐Iribarren, A.</creator><creator>Ramos, A.</creator><creator>Sánchez Romero, I.</creator><creator>Zaragoza, Ó.</creator><creator>Cuenca‐Estrella, M.</creator><creator>Rodríguez‐Baño, J.</creator><creator>Suárez, A. I.</creator><creator>Loza, A.</creator><creator>Martín‐Mazuelos, E.</creator><creator>Ruiz Pérez de Pipaón, M.</creator><creator>Garnacho, J.</creator><creator>Ortiz, C</creator><creator>Chávez, M.</creator><creator>Maroto, F. L.</creator><creator>Pemán, J.</creator><creator>Blanquer, J.</creator><creator>Navarro, D.</creator><creator>Camarena, J. J.</creator><creator>Zaragoza, R</creator><creator>Abril, V.</creator><creator>Gimeno, C.</creator><creator>Hernández, S.</creator><creator>Ezpeleta, G.</creator><creator>Bereciartua, E.</creator><creator>Hernández Almaraz, J. L.</creator><creator>Rivas, R. A.</creator><creator>Ayarza, R.</creator><creator>Planes, A. M.</creator><creator>Ruiz‐Camps, I.</creator><creator>Almirante, B.</creator><creator>Mensa, J.</creator><creator>Almela, M.</creator><creator>Gurgui, M.</creator><creator>Sánchez‐Reus, F.</creator><creator>Martínez‐Montauti, J.</creator><creator>Sierra, M.</creator><creator>Horcajada, J. P.</creator><creator>Sorli, L.</creator><creator>Gómez, J.</creator><creator>Gené, A.</creator><creator>Urrea, M.</creator><creator>Valerio, M.</creator><creator>Díaz‐Martín, A.</creator><creator>Puchades, F.</creator><creator>Mularoni, A.</creator><creator>Puerta‐Alcalde, P.</creator><creator>Morata, L.</creator><creator>Rodríguez‐Núñez, O.</creator><creator>Guerrero, M. A.</creator><creator>Carratalà, J.</creator><creator>Sabé, N.</creator><creator>Ayats, J.</creator><creator>Grau, I.</creator><creator>Calabuig, E.</creator><creator>Castro, I.</creator><creator>Cuéllar, S.</creator><creator>Fortún, J.</creator><creator>Martín‐Dávila, P.</creator><creator>Gómez‐García de la Pedrosa, E.</creator><creator>Pérez‐Ayala, A.</creator><creator>Losada, I.</creator><creator>Navarro, D.</creator><creator>Suarez, M. I.</creator><creator>Martín‐Gómez, M. T.</creator><creator>Almirante, B.</creator><creator>Rodríguez‐Alvarez, R.</creator><creator>López‐Soira, L.</creator><creator>Vena, A.</creator><creator>Valerio, M.</creator><creator>Bouza, E.</creator><creator>Guinea, J.</creator><creator>Martín, C.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5608-3090</orcidid><orcidid>https://orcid.org/0000-0002-0315-8001</orcidid><orcidid>https://orcid.org/0000-0002-0697-3992</orcidid></search><sort><creationdate>201912</creationdate><title>Candidemia in solid organ transplant recipients in Spain: Epidemiological trends and determinants of outcome</title><author>Fernández‐Ruiz, Mario ; Cardozo, Celia ; Salavert, Miguel ; Aguilar‐Guisado, Manuela ; Escolà‐Vergé, Laura ; Gioia, Francesca ; Montejo, Miguel ; Merino, Paloma ; Cuervo, Guillermo ; García‐Vidal, Carolina ; Aguado, José María ; Padilla, B ; Paño‐Pardo, J. R. ; García‐Rodríguez, J ; García Cerrada, C. ; Fortún, J ; Martín‐Dávila, P. ; Gómez‐García de la Pedrosa, E ; Ryan, P. ; Campelo, C. ; de los Santos Gil, I. ; Buendía, V. ; Pérez Gorricho, B. ; Alonso, M. ; Sanz Sanz, F. ; González Romo, F. ; Gorgolas, M. ; Gadea, I. ; Delgado‐Iribarren, A. ; Ramos, A. ; Sánchez Romero, I. ; Zaragoza, Ó. ; Cuenca‐Estrella, M. ; Rodríguez‐Baño, J. ; Suárez, A. I. ; Loza, A. ; Martín‐Mazuelos, E. ; Ruiz Pérez de Pipaón, M. ; Garnacho, J. ; Ortiz, C ; Chávez, M. ; Maroto, F. L. ; Pemán, J. ; Blanquer, J. ; Navarro, D. ; Camarena, J. J. ; Zaragoza, R ; Abril, V. ; Gimeno, C. ; Hernández, S. ; Ezpeleta, G. ; Bereciartua, E. ; Hernández Almaraz, J. L. ; Rivas, R. A. ; Ayarza, R. ; Planes, A. M. ; Ruiz‐Camps, I. ; Almirante, B. ; Mensa, J. ; Almela, M. ; Gurgui, M. ; Sánchez‐Reus, F. ; Martínez‐Montauti, J. ; Sierra, M. ; Horcajada, J. P. ; Sorli, L. ; Gómez, J. ; Gené, A. ; Urrea, M. ; Valerio, M. ; Díaz‐Martín, A. ; Puchades, F. ; Mularoni, A. ; Puerta‐Alcalde, P. ; Morata, L. ; Rodríguez‐Núñez, O. ; Guerrero, M. A. ; Carratalà, J. ; Sabé, N. ; Ayats, J. ; Grau, I. ; Calabuig, E. ; Castro, I. ; Cuéllar, S. ; Fortún, J. ; Martín‐Dávila, P. ; Gómez‐García de la Pedrosa, E. ; Pérez‐Ayala, A. ; Losada, I. ; Navarro, D. ; Suarez, M. I. ; Martín‐Gómez, M. T. ; Almirante, B. ; Rodríguez‐Alvarez, R. ; López‐Soira, L. ; Vena, A. ; Valerio, M. ; Bouza, E. ; Guinea, J. ; Martín, C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3535-be2ac400e29ec8a370b68497f5fa276de242d8e7ae4b87f0a6d117f64609edb13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antifungal Agents - pharmacology</topic><topic>Antifungal Agents - therapeutic use</topic><topic>Candida albicans - drug effects</topic><topic>Candida albicans - isolation & purification</topic><topic>Candida glabrata - drug effects</topic><topic>Candida glabrata - isolation & purification</topic><topic>Candidemia</topic><topic>Candidemia - drug therapy</topic><topic>Candidemia - epidemiology</topic><topic>Candidemia - microbiology</topic><topic>Confidence intervals</topic><topic>Drug Resistance, Fungal</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Fluconazole</topic><topic>Fluconazole - pharmacology</topic><topic>Fluconazole - therapeutic use</topic><topic>Fungal diseases</topic><topic>Fungicides</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Kidney transplantation</topic><topic>Male</topic><topic>Medical instruments</topic><topic>Microbial Sensitivity Tests</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multicenter Studies as Topic</topic><topic>Organ Transplantation - adverse effects</topic><topic>outcome</topic><topic>Prospective Studies</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Sepsis</topic><topic>Septic shock</topic><topic>solid organ transplantation</topic><topic>Spain - epidemiology</topic><topic>Transplant Recipients - statistics & numerical data</topic><topic>Transplants & implants</topic><topic>treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fernández‐Ruiz, Mario</creatorcontrib><creatorcontrib>Cardozo, Celia</creatorcontrib><creatorcontrib>Salavert, Miguel</creatorcontrib><creatorcontrib>Aguilar‐Guisado, Manuela</creatorcontrib><creatorcontrib>Escolà‐Vergé, Laura</creatorcontrib><creatorcontrib>Gioia, Francesca</creatorcontrib><creatorcontrib>Montejo, Miguel</creatorcontrib><creatorcontrib>Merino, Paloma</creatorcontrib><creatorcontrib>Cuervo, Guillermo</creatorcontrib><creatorcontrib>García‐Vidal, Carolina</creatorcontrib><creatorcontrib>Aguado, José María</creatorcontrib><creatorcontrib>Padilla, B</creatorcontrib><creatorcontrib>Paño‐Pardo, J. R.</creatorcontrib><creatorcontrib>García‐Rodríguez, J</creatorcontrib><creatorcontrib>García Cerrada, C.</creatorcontrib><creatorcontrib>Fortún, J</creatorcontrib><creatorcontrib>Martín‐Dávila, P.</creatorcontrib><creatorcontrib>Gómez‐García de la Pedrosa, E</creatorcontrib><creatorcontrib>Ryan, P.</creatorcontrib><creatorcontrib>Campelo, C.</creatorcontrib><creatorcontrib>de los Santos Gil, I.</creatorcontrib><creatorcontrib>Buendía, V.</creatorcontrib><creatorcontrib>Pérez Gorricho, B.</creatorcontrib><creatorcontrib>Alonso, M.</creatorcontrib><creatorcontrib>Sanz Sanz, F.</creatorcontrib><creatorcontrib>González Romo, F.</creatorcontrib><creatorcontrib>Gorgolas, M.</creatorcontrib><creatorcontrib>Gadea, I.</creatorcontrib><creatorcontrib>Delgado‐Iribarren, A.</creatorcontrib><creatorcontrib>Ramos, A.</creatorcontrib><creatorcontrib>Sánchez Romero, I.</creatorcontrib><creatorcontrib>Zaragoza, Ó.</creatorcontrib><creatorcontrib>Cuenca‐Estrella, M.</creatorcontrib><creatorcontrib>Rodríguez‐Baño, J.</creatorcontrib><creatorcontrib>Suárez, A. I.</creatorcontrib><creatorcontrib>Loza, A.</creatorcontrib><creatorcontrib>Martín‐Mazuelos, E.</creatorcontrib><creatorcontrib>Ruiz Pérez de Pipaón, M.</creatorcontrib><creatorcontrib>Garnacho, J.</creatorcontrib><creatorcontrib>Ortiz, C</creatorcontrib><creatorcontrib>Chávez, M.</creatorcontrib><creatorcontrib>Maroto, F. L.</creatorcontrib><creatorcontrib>Pemán, J.</creatorcontrib><creatorcontrib>Blanquer, J.</creatorcontrib><creatorcontrib>Navarro, D.</creatorcontrib><creatorcontrib>Camarena, J. J.</creatorcontrib><creatorcontrib>Zaragoza, R</creatorcontrib><creatorcontrib>Abril, V.</creatorcontrib><creatorcontrib>Gimeno, C.</creatorcontrib><creatorcontrib>Hernández, S.</creatorcontrib><creatorcontrib>Ezpeleta, G.</creatorcontrib><creatorcontrib>Bereciartua, E.</creatorcontrib><creatorcontrib>Hernández Almaraz, J. L.</creatorcontrib><creatorcontrib>Rivas, R. A.</creatorcontrib><creatorcontrib>Ayarza, R.</creatorcontrib><creatorcontrib>Planes, A. M.</creatorcontrib><creatorcontrib>Ruiz‐Camps, I.</creatorcontrib><creatorcontrib>Almirante, B.</creatorcontrib><creatorcontrib>Mensa, J.</creatorcontrib><creatorcontrib>Almela, M.</creatorcontrib><creatorcontrib>Gurgui, M.</creatorcontrib><creatorcontrib>Sánchez‐Reus, F.</creatorcontrib><creatorcontrib>Martínez‐Montauti, J.</creatorcontrib><creatorcontrib>Sierra, M.</creatorcontrib><creatorcontrib>Horcajada, J. P.</creatorcontrib><creatorcontrib>Sorli, L.</creatorcontrib><creatorcontrib>Gómez, J.</creatorcontrib><creatorcontrib>Gené, A.</creatorcontrib><creatorcontrib>Urrea, M.</creatorcontrib><creatorcontrib>Valerio, M.</creatorcontrib><creatorcontrib>Díaz‐Martín, A.</creatorcontrib><creatorcontrib>Puchades, F.</creatorcontrib><creatorcontrib>Mularoni, A.</creatorcontrib><creatorcontrib>Puerta‐Alcalde, P.</creatorcontrib><creatorcontrib>Morata, L.</creatorcontrib><creatorcontrib>Rodríguez‐Núñez, O.</creatorcontrib><creatorcontrib>Guerrero, M. A.</creatorcontrib><creatorcontrib>Carratalà, J.</creatorcontrib><creatorcontrib>Sabé, N.</creatorcontrib><creatorcontrib>Ayats, J.</creatorcontrib><creatorcontrib>Grau, I.</creatorcontrib><creatorcontrib>Calabuig, E.</creatorcontrib><creatorcontrib>Castro, I.</creatorcontrib><creatorcontrib>Cuéllar, S.</creatorcontrib><creatorcontrib>Fortún, J.</creatorcontrib><creatorcontrib>Martín‐Dávila, P.</creatorcontrib><creatorcontrib>Gómez‐García de la Pedrosa, E.</creatorcontrib><creatorcontrib>Pérez‐Ayala, A.</creatorcontrib><creatorcontrib>Losada, I.</creatorcontrib><creatorcontrib>Navarro, D.</creatorcontrib><creatorcontrib>Suarez, M. I.</creatorcontrib><creatorcontrib>Martín‐Gómez, M. T.</creatorcontrib><creatorcontrib>Almirante, B.</creatorcontrib><creatorcontrib>Rodríguez‐Alvarez, R.</creatorcontrib><creatorcontrib>López‐Soira, L.</creatorcontrib><creatorcontrib>Vena, A.</creatorcontrib><creatorcontrib>Valerio, M.</creatorcontrib><creatorcontrib>Bouza, E.</creatorcontrib><creatorcontrib>Guinea, J.</creatorcontrib><creatorcontrib>Martín, C.</creatorcontrib><creatorcontrib>CANDIPOP Project, the CANDI-Bundle Group</creatorcontrib><creatorcontrib>GEIRAS-GEMICOMED (SEIMC)REIPI</creatorcontrib><creatorcontrib>on behalf of the CANDIPOP Project, the CANDI‐Bundle Group</creatorcontrib><creatorcontrib>GEIRAS‐GEMICOMED (SEIMC)REIPI</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplant infectious disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fernández‐Ruiz, Mario</au><au>Cardozo, Celia</au><au>Salavert, Miguel</au><au>Aguilar‐Guisado, Manuela</au><au>Escolà‐Vergé, Laura</au><au>Gioia, Francesca</au><au>Montejo, Miguel</au><au>Merino, Paloma</au><au>Cuervo, Guillermo</au><au>García‐Vidal, Carolina</au><au>Aguado, José María</au><au>Padilla, B</au><au>Paño‐Pardo, J. R.</au><au>García‐Rodríguez, J</au><au>García Cerrada, C.</au><au>Fortún, J</au><au>Martín‐Dávila, P.</au><au>Gómez‐García de la Pedrosa, E</au><au>Ryan, P.</au><au>Campelo, C.</au><au>de los Santos Gil, I.</au><au>Buendía, V.</au><au>Pérez Gorricho, B.</au><au>Alonso, M.</au><au>Sanz Sanz, F.</au><au>González Romo, F.</au><au>Gorgolas, M.</au><au>Gadea, I.</au><au>Delgado‐Iribarren, A.</au><au>Ramos, A.</au><au>Sánchez Romero, I.</au><au>Zaragoza, Ó.</au><au>Cuenca‐Estrella, M.</au><au>Rodríguez‐Baño, J.</au><au>Suárez, A. I.</au><au>Loza, A.</au><au>Martín‐Mazuelos, E.</au><au>Ruiz Pérez de Pipaón, M.</au><au>Garnacho, J.</au><au>Ortiz, C</au><au>Chávez, M.</au><au>Maroto, F. L.</au><au>Pemán, J.</au><au>Blanquer, J.</au><au>Navarro, D.</au><au>Camarena, J. J.</au><au>Zaragoza, R</au><au>Abril, V.</au><au>Gimeno, C.</au><au>Hernández, S.</au><au>Ezpeleta, G.</au><au>Bereciartua, E.</au><au>Hernández Almaraz, J. L.</au><au>Rivas, R. A.</au><au>Ayarza, R.</au><au>Planes, A. M.</au><au>Ruiz‐Camps, I.</au><au>Almirante, B.</au><au>Mensa, J.</au><au>Almela, M.</au><au>Gurgui, M.</au><au>Sánchez‐Reus, F.</au><au>Martínez‐Montauti, J.</au><au>Sierra, M.</au><au>Horcajada, J. P.</au><au>Sorli, L.</au><au>Gómez, J.</au><au>Gené, A.</au><au>Urrea, M.</au><au>Valerio, M.</au><au>Díaz‐Martín, A.</au><au>Puchades, F.</au><au>Mularoni, A.</au><au>Puerta‐Alcalde, P.</au><au>Morata, L.</au><au>Rodríguez‐Núñez, O.</au><au>Guerrero, M. A.</au><au>Carratalà, J.</au><au>Sabé, N.</au><au>Ayats, J.</au><au>Grau, I.</au><au>Calabuig, E.</au><au>Castro, I.</au><au>Cuéllar, S.</au><au>Fortún, J.</au><au>Martín‐Dávila, P.</au><au>Gómez‐García de la Pedrosa, E.</au><au>Pérez‐Ayala, A.</au><au>Losada, I.</au><au>Navarro, D.</au><au>Suarez, M. I.</au><au>Martín‐Gómez, M. T.</au><au>Almirante, B.</au><au>Rodríguez‐Alvarez, R.</au><au>López‐Soira, L.</au><au>Vena, A.</au><au>Valerio, M.</au><au>Bouza, E.</au><au>Guinea, J.</au><au>Martín, C.</au><aucorp>CANDIPOP Project, the CANDI-Bundle Group</aucorp><aucorp>GEIRAS-GEMICOMED (SEIMC)REIPI</aucorp><aucorp>on behalf of the CANDIPOP Project, the CANDI‐Bundle Group</aucorp><aucorp>GEIRAS‐GEMICOMED (SEIMC)REIPI</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Candidemia in solid organ transplant recipients in Spain: Epidemiological trends and determinants of outcome</atitle><jtitle>Transplant infectious disease</jtitle><addtitle>Transpl Infect Dis</addtitle><date>2019-12</date><risdate>2019</risdate><volume>21</volume><issue>6</issue><spage>e13195</spage><epage>n/a</epage><pages>e13195-n/a</pages><issn>1398-2273</issn><eissn>1399-3062</eissn><abstract>Background
Despite being considered a high‐risk population for invasive fungal disease, specific features of candidemia among solid organ transplant (SOT) recipients remain poorly characterized.
Methods
We compiled prospective data from two multicenter studies on candidemia performed over two consecutive periods in Spain: the CANDIPOP Study (2010‐2011) and the CANDI‐Bundle Study (2016‐2018). Episodes diagnosed in adult SOT recipients in 10 participating centers were included. Risk factors for clinical failure (all‐cause 7‐day mortality and/or persistent candidemia for ≥72 hours) and 30‐day mortality were investigated by univariate analysis.
Results
We included 55 episodes of post‐transplant candidemia (32 and 23 of which occurred during the first and second periods). Kidney (38.2%) and liver recipients (30.9%) were the most common populations. Candida albicans accounted for 27.3% of episodes. The proportion of C glabrata increased over time (18.8% vs 30.4% for the first and second periods). There were no differences in the rate of fluconazole non‐susceptible isolates (50.0% vs 60.0%, respectively). Clinical failure and 30‐day mortality occurred in 25.5% and 27.3% of episodes and were associated with the severity of candidemia (Pitt score and severe sepsis/septic shock). Kidney transplantation (unadjusted odds ratio [uOR]: 0.17; 95% confidence interval [CI]: 0.03‐0.85; P‐value = .020), early catheter removal (uOR: 0.15; 95% CI: 0.03‐0.76; P‐value = .013), and appropriate early antifungal therapy (uOR: 0.14; 95% CI: 0.02‐0.89; P‐value = .041) were protective for 30‐day mortality.
Conclusions
High rates of non‐albicans species and fluconazole non‐susceptibility must be taken into account to optimize therapeutic management and outcomes in SOT recipients with candidemia.</abstract><cop>Denmark</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31610077</pmid><doi>10.1111/tid.13195</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-5608-3090</orcidid><orcidid>https://orcid.org/0000-0002-0315-8001</orcidid><orcidid>https://orcid.org/0000-0002-0697-3992</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1398-2273 |
| ispartof | Transplant infectious disease, 2019-12, Vol.21 (6), p.e13195-n/a |
| issn | 1398-2273 1399-3062 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2305802027 |
| source | MEDLINE; Wiley-Blackwell Full Collection |
| subjects | Adult Aged Antifungal Agents - pharmacology Antifungal Agents - therapeutic use Candida albicans - drug effects Candida albicans - isolation & purification Candida glabrata - drug effects Candida glabrata - isolation & purification Candidemia Candidemia - drug therapy Candidemia - epidemiology Candidemia - microbiology Confidence intervals Drug Resistance, Fungal Epidemiology Female Fluconazole Fluconazole - pharmacology Fluconazole - therapeutic use Fungal diseases Fungicides Hospital Mortality Humans Kidney transplantation Male Medical instruments Microbial Sensitivity Tests Middle Aged Mortality Multicenter Studies as Topic Organ Transplantation - adverse effects outcome Prospective Studies Risk analysis Risk Factors Sepsis Septic shock solid organ transplantation Spain - epidemiology Transplant Recipients - statistics & numerical data Transplants & implants treatment |
| title | Candidemia in solid organ transplant recipients in Spain: Epidemiological trends and determinants of outcome |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-01T06%3A32%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Candidemia%20in%20solid%20organ%20transplant%20recipients%20in%20Spain:%20Epidemiological%20trends%20and%20determinants%20of%20outcome&rft.jtitle=Transplant%20infectious%20disease&rft.au=Fern%C3%A1ndez%E2%80%90Ruiz,%20Mario&rft.aucorp=CANDIPOP%20Project,%20the%20CANDI-Bundle%20Group&rft.date=2019-12&rft.volume=21&rft.issue=6&rft.spage=e13195&rft.epage=n/a&rft.pages=e13195-n/a&rft.issn=1398-2273&rft.eissn=1399-3062&rft_id=info:doi/10.1111/tid.13195&rft_dat=%3Cproquest_cross%3E2326813553%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2326813553&rft_id=info:pmid/31610077&rfr_iscdi=true |