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Dynamics and Predictors of Mortality Due to Candidemia Caused by Different Candida Species: Comparison of Intensive Care Unit-Associated Candidemia (ICUAC) and Non-ICUAC

 Yong Jun Kwon  ;  Eun Jeong Won  ;  Seok Hoon Jeong  ;  Kyeong Seob Shin  ;  Jeong Hwan Shin  ;  Young Ree Kim  ;  Hyun Soo Kim  ;  Young Ah Kim  ;  Young Uh  ;  Taek Soo Kim  ;  Jae Hyeon Park  ;  Jaehyeon Lee  ;  Min Ji Choi  ;  Seung A Byun  ;  Soo Hyun Kim  ;  Jong Hee Shin 
 JOURNAL OF FUNGI, Vol.7(8) : 597, 2021-08 
Journal Title
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Candida species ; ICU ; candidemia ; lack of antifungal therapy ; mortality
We investigated mortality and predictors of mortality due to intensive care unit-associated candidemia (ICUAC) versus non-ICUAC by Candida species. This study included all candidemia cases in 11 hospitals from 2017 to 2018 in South Korea. The all-cause mortality rates in all 370 patients with ICUAC were approximately twofold higher than those in all 437 patients with non-ICUAC at 7 days (2.3-fold, 31.1%/13.3%), 30 days (1.9-fold, 49.5%/25.4%), and 90 days (1.9-fold, 57.8%/30.9%). Significant species-specific associations with 7- and 30-day ICUAC-associated mortality were not observed. Multivariate analysis revealed that ICU admission was an independent predictor of Candida glabrata (OR, 2.07-2.48) and Candida parapsilosis-associated mortality (OR, 6.06-11.54). Fluconazole resistance was a predictor of C. glabrata-associated mortality (OR, 2.80-5.14). Lack (less than 3 days) of antifungal therapy was the strongest predictor of 7-day mortality due to ICUAC caused by Candida albicans (OR, 18.33), Candida tropicalis (OR, 10.52), and C. glabrata (OR, 21.30) compared with 30- and 90-day mortality (OR, 2.72-6.90). C. glabrata ICUAC had a stronger association with lack of antifungal therapy (55.2%) than ICUAC caused by other species (30.6-36.7%, all p < 0.05). Most predictors of mortality associated with ICUAC were distinct from those associated with non-ICUAC and were mediated by Candida species.
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1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Jeong, Seok Hoon(정석훈) ORCID logo https://orcid.org/0000-0001-9290-897X
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