Although the characteristics of complicated candidaemia are well known, uncomplicated disease remains undefined. Recommended treatment duration for candidaemia is 14 days after bloodstream infection i...

AbstractObjectives. Candida glabrata is the second most common species responsible for invasive candidiasis, including candidaemia. Echinocandins are typic

Although the characteristics of complicated candidaemia are well known, uncomplicated disease remains undefined. Recommended treatment duration for candidaemia is 14 days after bloodstream infection i...

Invasive candidiasis is a life-threatening infection associated with high morbidity, mortality and healthcare costs in both general and critical care settings. Timely diagnosis and adequate antifunga....

Although the characteristics of complicated candidaemia are well known, uncomplicated disease remains undefined. Recommended treatment duration for candidaemia is 14 days after bloodstream infection i...

Background The efficacy and safety of rezafungin in invasive candidiasis (IC) and candidaemia was demonstrated in the Phase 2 STRIVE and Phase 3 ReSTORE trials, and an additional cohort of patients ...

Although the characteristics of complicated candidaemia are well known, uncomplicated disease remains undefined. Recommended treatment duration for candidaemia is 14 days after bloodstream infection i...

Candida species are the predominant cause of fungal infections in patients treated in hospital, contributing substantially to morbidity and mortality. Candidaemia and other forms of invasive candidias...

Candidaemia in children is associated with high mortality. The epidemiology of Candida bloodstream infection is changing with rising rates of fluconazole resistance worldwide and the emergence of nov...

Candida species are the predominant cause of fungal infections in patients treated in hospital, contributing substantially to morbidity and mortality. Candidaemia and other forms of invasive candidias...

The AURIS score provides a pragmatic tool for risk stratification among C auris-colonised ICU patients, with value in identifying those at low risk of candidaemia, reducing unnecessary empirical antif...

The AURIS score provides a pragmatic tool for risk stratification among C auris-colonised ICU patients, with value in identifying those at low risk of candidaemia, reducing unnecessary empirical antif...

Achieving and maintaining therapeutic drug exposures with antifungals can be challenging in special patient populations, such as those with organ dysf…

Candida species are the predominant cause of fungal infections in patients treated in hospital, contributing substantially to morbidity and mortality. Candidaemia and other forms of invasive candidias...

A bedside scoring system to assess the severity of disease is lacking for candidaemia. The Pitt candidaemia score (PCS) was evaluated for its association with mortality.MethodsThe PCS consists of five components, namely dialysis, hypotension, mechanical ventilation, cardiac arrest and mental status. Patients were classified into four categories according to their PCS. The correlation between PCS category at blood culture collection and 30 day mortality was studied individually for five Candida species.ResultsLeading rates of mortality were observed in Candida tropicalis and Candida krusei. The interval from inoculation to positive culture was 19.4 ± 9.7 h for C. tropicalis and 21.3 ± 5.6 h for C. krusei; these intervals were significantly shorter than those for other Candida species. In a Kaplan–Meier survival curve, a significant risk stratification by PCS category was demonstrated in all Candida species. A high PCS was an independent risk factor for mortality, and source control decreased the risk for C. tropicalis and Candida glabrata infections. Regarding antifungal therapy, the median PCS was 8 for liposomal amphotericin B, 2 for echinocandins and 0 for azoles, and this trend was consistent among four Candida species.ConclusionsThe mortality rate was well stratified by the PCS, and the PCS affected the selection of antifungals. A future prospective study is required for the PCS in guiding therapy for candidaemia.

AbstractObjectivesA candidaemia risk prediction model by Keighley et al. stratified patients with candidaemia into <20% or ≥20% predicted 30-day all-cause mortality based on age >65 years, intensive care unit admission, chronic organ dysfunction, no recent surgery, haematological malignancy, source of candidaemia, and prolonged antibiotic therapy. We aimed to validate this model in a contemporary patient cohort.MethodsThis retrospective cohort study was conducted at a 671-bed tertiary hospital comprising both abdominal solid organ and allogeneic stem cell transplant services (Melbourne, Australia). All adult inpatients with Candida spp. isolated from blood cultures from 2018 to 2023 were included. Model performance was evaluated using logistic regression and area under the receiver operating characteristic curve.ResultsA total of 121 patients with candidaemia were identified, of whom 40 (33%) died within 30 days. The median mortality risk score was 3 (interquartile range, 2.5–4.5). The risk score demonstrated good discriminative ability in predicting mortality in our cohort (area under the receiver operating characteristic curve, 0.759), with a score of 2 providing a discriminative cut off (11% mortality score ≤2, 43% mortality score >2, and negative predictive value 89.2%). Patients aged >65 years, intensive care unit admission, and a gastrointestinal or unknown source of candidaemia were independently associated with mortality.ConclusionsThe candidaemia mortality risk predictive model by Keighley et al. performed well in our contemporary and complex patient population. This model can be utilized to risk-stratify patients into low and high mortality risk to assist with candidaemia management and antifungal stewardship.Graphical AbstractDownload: Download high-res image (338KB)Download: Download full-size image

Candida species are the predominant cause of fungal infections in patients treated in hospital, contributing substantially to morbidity and mortality. Candidaemia and other forms of invasive candidias...

Candida species are the predominant cause of fungal infections in patients treated in hospital, contributing substantially to morbidity and mortality. Candidaemia and other forms of invasive candidias...

Candida species are the predominant cause of fungal infections in patients treated in hospital, contributing substantially to morbidity and mortality. Candidaemia and other forms of invasive candidias...

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BMC Infectious Diseases - Candidaemia is a leading cause of hospital-acquired bloodstream infections, especially in intensive care unit (ICU) patients, and is associated with high mortality and...