Abstract
In an effort to standardize practice, the European Confederation of Medical Mycology (ECMM) developed the European Confederation of Medical Mycology Quality of Clinical Candidaemia Management (EQUAL) Candida score. This study investigated the utility of the EQUAL Candida score in predicting mortality in patients with candidemia admitted between January 2004 and July 2019. A total of 142 cases were included in the study, and 43.6% died within 30 days of candidemia diagnosis. There were no significant differences between survivors and non-survivors in terms of comorbidities predisposing to candidemia, except for malignancy (p = 0.021). The overall mean EQUAL score was 11.5 in the total population and 11.8 ± 3.82 and 11.03 ± 4.59 in survivors and non-survivors, respectively. When patients with a central venous catheter (CVC) were considered alone, survivors were found to have significantly higher scores than non-survivors (13.1 ± 3.19 vs. 11.3 ± 4.77, p = 0.025). When assessing components of the EQUAL Score separately, only candida speciation (p = 0.013), susceptibility testing (p = 0.012) and echocardiography results (p = 0.012) were significantly associated with a lower case-fatality rate. A higher EQUAL Candida score was able to predict a lower case-fatality rate in patients with a CVC.
Highlights
The incidence of candidemia has been rising worldwide over the last decades, amounting to be the fourth highest bloodstream infection in hospitalized patients [1]
The main remaining controversial points in candidemia management include the indications for ophthalmic examination and echocardiography as well as the need for removal of central lines in patients with central line-associated bloodstream infection [9]
AUmALonsgcotrheefotoutnadl pinattiheinstsptuodpyuliasthioignh, ethr ethoavneorathllemrsefoanunsdcoirnethwealsit1e1ra.5t.uTreh,eramnegainng EfQroUmAaLmsceoarne sfcoournedofin8.t9h1isfrsotumday misuhlitgicheenrtethr asntuodtyheinrsTfaoiuwnadn i[n13t]hteoli9t.e9raatnudre1,1r.a0n4gfirnogm frsotumdiaesmdeoannesicnoGreeromf 8a.n9y1 afnrodmthae mUnuiltteicdenKtienrgsdtoumdy, rienspTeacitwivaenly[1[134],1to6]9. .A9 amnedd1ia1n.0E4QfrUoAmL stsucodrieesofd6on(Ientienr-GquearmrtialneyRaanngde t(hIQe RU)n6i-t9e)dfoKripngatdieonmts, wreistpheocutitvCelVyC[s14a,n1d6]1. 1A(IQmRed6i-a1n4) EfQorUpAaLtiesncotsrewoifth6 C(IVntCers-wquaasrrtielpeoRratendgein(IaQPRo)r6t-u9g)ufoesreptaetrietinatrsywcaitrheohuotsCpVitCals[a1n2]d, w11h(eIrQeRas, 6-14) for patients with central venous catheter (CVC) was reported in a Portuguese tertiary care hospital [12], whereas, in Korea, a median EQUAL score of 17 (14–18) for patients with CVCs and 14 (12–15) for patients without CVCs were reported [15]
Summary
The incidence of candidemia has been rising worldwide over the last decades, amounting to be the fourth highest bloodstream infection in hospitalized patients [1]. This is believed to be due to the increase in predisposing factors, such as immunosuppression, critical illness, advanced age, the use of broad-spectrum antibiotics, as well as indwelling venous catheters [2–5]. The management of candidemia and guidelines have been evolving over the past few years to address certain controversial areas [6–8]. The main remaining controversial points in candidemia management include the indications for ophthalmic examination and echocardiography as well as the need for removal of central lines in patients with central line-associated bloodstream infection [9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
