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Cited by 438Antifungal resistance and susceptibilityFungal Infections and StudiesOcular Infections and Treatments

Excess mortality, hospital stay, and cost due to candidemia: a case-control study using data from population-based candidemia surveillance

Morgan, Juliette, Meltzer, Martin I., Plikaytis, Brian D., Sofair, Andre N., Huie-White, Sharon, Wilcox, Steven, Harrison, Lee H., Seaberg, Eric C. +2 more·2005·Infection Control & Hospital Epidemiology
DOI 10.1086/502581
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Abstract

Objective: To determine the mortality, hospital stay, and total hospital charges and cost of hospitalization attributable to candidemia by comparing patients with candidemia with control-patients who have otherwise similar illnesses. Prior studies lack broad patient and hospital representation or cost-related information that accurately reflects current medical practices. Design: Our case-control study included case-patients with candidemia and their cost-related data, ascertained from laboratory-based candidemia surveillance conducted among all residents of Connecticut and Baltimore and Baltimore County, Maryland, during 1998 to 2000. Control-patients were matched on age, hospital type, admission year, discharge diagnoses, and duration of hospitalization prior to candidemia onset. Results: We identified 214 and 529 sets of matched case-patients and control-patients from the two locations, respectively. Mortality attributable to candidemia ranged between 19% and 24%. On multivariable analysis, candidemia was associated with mortality (OR, 5.3 for Connecticut and 8.5 for Baltimore and Baltimore County;P< .05), whereas receiving adequate treatment was protective (OR, 0.5 and 0.4 for the two locations, respectively;P< .05). Candidemia itself did not increase the total hospital charges and cost of hospitalization; when treatment status was accounted for, having received adequate treatment for candidemia significantly increased the total hospital charges and cost of hospitalization ($6,000 to $29,000 and $3,000 to $22,000, respectively) and the length of stay (3 to 13 days). Conclusion: Our findings underscore the burden of candidemia, particularly regarding the risk of death, length of hospitalization, and cost associated with treatment (Infect Control Hosp Epidemiol 2005;26:540-547).

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Crossref · 10.1086/502581

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  • Mortality attributable to candidemia, estimated by carefully matched retrospective cohort studies, ranges from 10% to 49%.

    “Carefully matched, retrospective cohort studies have been undertaken to estimate mortality attributable to candidemia and report rates ranging from 10% to 49%.[10][11][12][13][14][15]”

    From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [10]

  • Patients with invasive candidiasis have excessive rates of inappropriate initial therapy and higher mortality than intensive care unit patients with bacterial infections.

    “Studies on patients with IC have similarly shown excessive rates of inappropriate initial therapy and even higher mortality than infections caused by bacterial pathogens in the ICU setting.10,14,33,34,[42][43][44][45][46][47]”

    From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [10]

  • The added hospital cost from candidemia is as much as $40,000 per case.

    “Estimates from numerous studies suggest the added hospital cost is as much as $40,000 per case.[10][11][12][16][17][18][19][20]”

    From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [10]

  • Inadequate dosing of antifungals in patients with invasive candidiasis is associated with increased length of hospital stay, health care costs, morbidity, and mortality.

    “Numerous reports have documented the association between inadequate dosing of antifungals in patients with IC and increased length of hospital stay, health care costs, morbidity, and mortality.”

    From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [10]

  • Candidemia brings a substantial economic burden, involving on average three to 13 days of hospitalization in the US, with total associated costs ranging from $6000 to $29,000.

    “In addition, candidemia brings a substantial economic burden, involving, on average, three to 13 days of hospitalization in the US, with total associated costs ranging from $6000 to $29,000 [5].”

    From Evolutionary Emergence of Drug Resistance in Candida Opportunistic Pathogens (2018) · cites this paper as [5]

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Authors
Morgan, J., Meltzer, M. I., Plikaytis, B. D., Sofair, A. N., Huie-White, S., Wilcox, S., Harrison, L. H., Seaberg, E. C., Hajjeh, R. A., & Teutsch, S. M.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • Johns Hopkins University (US)
  • Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
Corresponding author
Morgan, Juliette
ORCID
Venue
Infection Control & Hospital Epidemiology
Publisher
Cambridge University Press (CUP)
Published
2005-06
Volume
26
Issue
6
Pages
540-547
ISSN
  • 0899-823X (ISSN-L)
  • 1559-6834
DOI
10.1086/502581
OpenAlex
W2138648278
Semantic Scholar
fbb5a839e0dc3b43795b4bba8e920640a069b23b
Cited by
437
References
26
Citations by year
2026: 9 · 2025: 13 · 2024: 16 · 2023: 15 · 2022: 18 · 2021: 15 · 2020: 21 · 2019: 24 · 2018: 10 · 2017: 19 · 2016: 24 · 2015: 27 · 2014: 18 · 2013: 26 · 2012: 36
FWCI
11.94
Type
journal article
Language
en
Open access
closed
Licence
www.cambridge.org/core/terms (unspecified, 4038 d)
Locations
  • Infection Control and Hospital Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
  • Health Sciences › Medicine › Ophthalmology › Ocular Infections and Treatments
Keywords
candidemia, excess mortality, length of hospital stay, hospital costs, fungemia, Connecticut, Baltimore
MeSH terms
Adolescent, Adult, Candidiasis, Child, Child, Preschool, Connecticut, Cross Infection, Female, Humans, Infant, Length of Stay, Male, Middle Aged, Population Surveillance, Baltimore, Multivariate Analysis, Linear Models, Case-Control Studies, Fungemia, Hospital Mortality, Cost of Illness, Age Distribution, Hospital Costs, Hospital Charges

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