Invasive Candida infections in surgical patients in intensive care units: a prospective, multicentre survey initiated by the European Confederation of Medical Mycology (ECMM) (2006–2008)
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A prospective, observational, multicentre study of invasive candidosis (IC) in surgical patients in intensive care units (ICUs) was conducted from 2006 to 2008 in 72 ICUs in 14 European countries. A total of 779 patients (62.5% males, median age 63 years) with IC were included. The median rate of candidaemia was 9 per 1000 admissions. In 10.8% the infection was already present at the time of admission to ICU. Candida albicans accounted for 54% of the isolates, followed by Candida parapsilosis 18.5%, Candida glabrata 13.8%, Candida tropicalis 6%, Candida krusei 2.5%, and other species 5.3%. Infections due to C. krusei (57.9%) and C. glabrata (43.6%) had the highest crude mortality rate. The most common preceding surgery was abdominal (51.5%), followed by thoracic (20%) and neurosurgery (8.2%). Candida glabrata was more often isolated after abdominal surgery in patients ≥60 years, and C. parapsilosis was more often isolated in neurosurgery and multiple trauma patients as well as children ≤1 year of age. The most common first-line treatment was fluconazole (60%), followed by caspofungin (18.7%), liposomal amphotericin B (13%), voriconazole (4.8%) and other drugs (3.5%). Mortality in surgical patients with IC in ICU was 38.8%. Multivariate analysis showed that factors independently associated with mortality were: patient age ≥60 years (hazard ratio (HR) 1.9, p 0.001), central venous catheter (HR 1.8, p 0.05), corticosteroids (HR 1.5, p 0.03), not receiving systemic antifungal treatment for IC (HR 2.8, p <0.0001), and not removing intravascular lines (HR 1.6, p 0.02).
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In the European Confederation of Medical Mycology Candida studies, the proportion of C. albicans causing candidemia decreased from 56.4% in 1997-1999, to 54% in 2006-2008, to 46.2% in 2018, with corresponding increases in non-albicans species.
“While that decreasing trend is ubiquitous, with the series of multicenter European Confederation of Medical Mycology (ECMM) Candida studies showing the proportion of C. albicans causing candidemia decreased from 56.4% in 1997–1999,57 to 54% in 2006–2008,58 to 46.2% in 201856 with corresponding increases in non-albicans species (Table 1), there are important geographic differences.”
From Epidemiology of Invasive Candidiasis (2024) · cites this paper as [58]
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Experimental — accuracy not yet measuredSummarizing all of Europe, the increase in the proportion of C. glabrata between 2006-2008 (13.8%) and 2018 (21.4%) has been striking.
“Summarizing all of Europe together, the increase in the proportion of C. glabrata between 2006–2008 (13.8%)58 to 2018 (21.4%)56 has been striking.”
From Epidemiology of Invasive Candidiasis (2024) · cites this paper as [58]
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Aspergillus-Nachweis im Atemwegsmaterial
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Opportunistic and Systemic Fungi
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- Authors
- Klingspor, L., Tortorano, A. M., Peman, J., Willinger, B., Hamal, P., Sendid, B., Velegraki, A., Kibbler, C., Meis, J. F., Sabino, R., Ruhnke, M., Arikan-Akdagli, S., Salonen, J., & Dóczi, I.
- Affiliations
- Karolinska University Hospital (SE)
- University of Milan (IT)
- Medical University of Vienna (AT)
- Palacký University Olomouc (CZ)
- Inserm (FR)
- National and Kapodistrian University of Athens (GR)
- The Royal Free Hospital (GB)
- Radboud University Medical Center (NL)
- National Institute of Health Dr. Ricardo Jorge (PT)
- Charité – Universitätsmedizin Berlin (DE)
- Päijät-Hämeen Keskussairaala (FI)
- University of Szeged (HU)
- Corresponding author
- Klingspor, L.
- ORCID
- Venue
- Clinical Microbiology and Infection
- Publisher
- Elsevier BV
- Published
- 2015-01
- Volume
- 21
- Issue
- 1
- Pages
- 87.e1-87.e10
- ISSN
- 1198-743X (ISSN-L)
- OpenAlex
- W2092769417
- Semantic Scholar
- 7f9c9446269d3ed0adeb783a6c8cdd8ace7fac22
- Cited by
- 137
- References
- 35
- Citations by year
- 2026: 3 · 2025: 13 · 2024: 15 · 2023: 13 · 2022: 8 · 2021: 6 · 2020: 15 · 2019: 14 · 2018: 16 · 2017: 17 · 2016: 13 · 2015: 4
- FWCI
- 7.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Clinical Microbiology and Infection (publishedVersion)
- PubMed (publishedVersion)
- SZTE Publicatio Repozitórium (University of Szeged) (acceptedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- Hacettepe University Institutional Repository (hacettepe.edu.tr) (submittedVersion, other-oa)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- Merck Sharp and Dohme
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Keywords
- invasive candidiasis, candidemia, intensive care unit, surgical patients, Candida albicans, Candida parapsilosis, Candida glabrata, Candida krusei, Candida tropicalis, mortality risk factors, antifungal therapy, central venous catheters, corticosteroids, abdominal surgery, neurosurgery, polytrauma, fluconazole, caspofungin, liposomal amphotericin B, voriconazole
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Antifungal Agents, Candida, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Intensive Care Units, Male, Middle Aged, Prospective Studies, Surgical Procedures, Operative, Antibiotic Prophylaxis, Young Adult, Candidiasis, Invasive
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