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Arnaldo Lopes Colombo - One of the best experts on this subject based on the ideXlab platform.
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outbreak of Candidemia caused by fluconazole resistant candida parapsilosis strains in an intensive care unit
BMC Infectious Diseases, 2016Co-Authors: Henrique Marconi Sampaio Pinhati, Luiz Augusto Casulari, Ana Carolina Remondi Souza, Ricardo Andreotti Siqueira, Camila Maria Gomes Damasceno, Arnaldo Lopes ColomboAbstract:Candidemia is an increasing problem in tertiary care hospitals worldwide. Here, we report the first outbreak of Candidemia caused by fluconazole-resistant C. parapsilosis (FRCP) strains in Brazil. This was a cross-sectional study of clinical and microbiological data of all candidemic episodes diagnosed from July 2011 to February 2012 in a 200-bed tertiary care hospital. Initial yeast identification and susceptibility testing were performed using the VITEK 2 - System. Isolates of Candida spp. resistant to fluconazole were sent to a reference laboratory (LEMI-UNIFESP) for further molecular identification and confirmation of resistance by CLSI microdilution test. A multivariate analysis was conducted to identify factors associated with FRCP infection. We identified a total of 40 critically ill patients with Candidemia (15 women) with a median age of 70 years. The incidence of Candidemia was 6 cases/1,000 patients admissions, including 28 cases (70 %) of infection with C. parapsilosis, 21 of which (75 %) were resistant to fluconazole. In only 19 % of FRCP Candidemia cases had fluconazole been used previously. The results of our study indicated that diabetes is a risk factor for FRCP Candidemia (p = 0.002). Overall, mortality from Candidemia was 45 %, and mortality from episodes of FRCP infections was 42.9 %. The clustering of incident cases in the ICU and molecular typing of strains suggest horizontal transmission of FRCP. Accurate vigilant monitoring for new nosocomial strains of FRCP is required.
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Special ArticleRecommendations for the management of Candidemia in children in Latin AmericaRecomendaciones para el manejo de la Candidemia en niños en América Latina
Revista iberoamericana de micologia, 2013Co-Authors: María Elena Santolaya, Arnaldo Lopes Colombo, Iris Nora Tiraboschi, Flavio De Queiroz Telles, Tito Alvarado Matute, Jeannete Zurita, Jorge E. Cortes, Luis Thompson-moya, Manuel Guzman-blanco, Jose SifuentesAbstract:Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of Candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of Candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of Candidemia. This publication, 'Recommendations for the management of Candidemia in children in Latin America', was written to provide guidance to healthcare professionals on the management of children who have, or who are at risk of, Candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of Candidemia in children in Latin America' includes prophylaxis, empirical therapy, therapy for proven Candidemia, patient work-up following diagnosis of Candidemia, duration of Candidemia treatment, and central venous catheter management in children with Candidemia. This manuscript is the third of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of Candidemia in Latin America', 'Recommendations for the management of Candidemia in adults in Latin America', and 'Recommendations for the management of Candidemia in neonates in Latin America'.
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Recommendations for the management of Candidemia in children in Latin America.
Revista iberoamericana de micologia, 2013Co-Authors: María Elena Santolaya, Arnaldo Lopes Colombo, Iris Nora Tiraboschi, Flavio De Queiroz Telles, Tito Alvarado Matute, Jeannete Zurita, Jorge E. Cortes, Luis Thompson-moya, Manuel Guzman-blanco, Jose SifuentesAbstract:Abstract Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of Candidemia in Latin America is warranted. ‘Recommendations for the diagnosis and management of Candidemia’ are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of Candidemia. This publication, ‘Recommendations for the management of Candidemia in adults in Latin America’, was written to provide guidance to healthcare professionals on the management of adults who have, or who are at risk of, Candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. ‘Recommendations for the management of Candidemia in adults in Latin America’ includes prophylaxis, empirical therapy, therapy for proven Candidemia, patient work-up following diagnosis of Candidemia, duration of Candidemia treatment, and central venous catheter management in patients with Candidemia. This manuscript is the second of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: ‘Recommendations for the diagnosis of Candidemia in Latin America’, ‘Recommendations for the management of Candidemia in children in Latin America’, and ‘Recommendations for the management of Candidemia in neonates in Latin America’. This article is also published in Spanish in this issue. It can be found in http://dx.doi.org/10.1016/j.riam.2013.06.001
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Recommendations for the diagnosis of Candidemia in Latin America
Revista iberoamericana de micologia, 2013Co-Authors: Arnaldo Lopes Colombo, Iris Nora Tiraboschi, María Elena Santolaya, Flavio De Queiroz Telles, Tito Alvarado Matute, Jeannete Zurita, Jorge E. Cortes, Manuel Guzman-blanco, Juan Echevarría, Jose SifuentesAbstract:Abstract Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of Candidemia in Latin America is warranted. ‘Recommendations for the diagnosis and management of Candidemia’ are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of Candidemia. This publication, ‘Recommendations for the diagnosis of Candidemia in Latin America’, was written to provide guidance to healthcare professionals on the diagnosis of Candidemia, as well as on the usefulness and application of susceptibility testing in patients who have a confirmed diagnosis of Candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. ‘Recommendations for the diagnosis of Candidemia in Latin America’ includes diagnostic methods used to detect Candidemia, Candida species identification, and susceptibility testing. The availability of methods, their costs and treatment settings are considered. This manuscript is the first of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: ‘Recommendations for the management of Candidemia in adults in Latin America’, ‘Recommendations for the management of Candidemia in children in Latin America’, and ‘Recommendations for the management of Candidemia in neonates in Latin America’. This article is also published in Spanish in this issue. It can be found in http://dx.doi.org/10.1016/j.riam.2013.05.009
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Recommendations for the diagnosis of Candidemia in Latin America. Grupo Proyecto Épico
Revista iberoamericana de micologia, 2013Co-Authors: Arnaldo Lopes Colombo, Iris Nora Tiraboschi, María Elena Santolaya, Flavio De Queiroz Telles, Jeannete Zurita, Manuel Guzman-blanco, Juan Echevarría, Jorge Alberto Cortes, Tito Alvarado Matute, Jose SifuentesAbstract:Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of Candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of Candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of Candidemia. This publication, 'Recommendations for the diagnosis of Candidemia in Latin America', was written to provide guidance to healthcare professionals on the diagnosis of Candidemia, as well as on the usefulness and application of susceptibility testing in patients who have a confirmed diagnosis of Candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the diagnosis of Candidemia in Latin America' includes diagnostic methods used to detect Candidemia, Candida species identification, and susceptibility testing. The availability of methods, their costs and treatment settings are considered. This manuscript is the first of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the management of Candidemia in adults in Latin America', 'Recommendations for the management of Candidemia in children in Latin America', and 'Recommendations for the management of Candidemia in neonates in Latin America'.
Rosemary Hollick - One of the best experts on this subject based on the ideXlab platform.
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the changing epidemiology of Candidemia in the united states injection drug use as an increasingly common risk factor active surveillance in selected sites united states 2014 2017
Clinical Infectious Diseases, 2020Co-Authors: Alexia Y Zhang, Sarah Shrum, Sabrina Williams, Sarah Petnic, Joelle Nadle, Helen Johnston, Devra Barter, Brittany Vonbank, Lindsay Bonner, Rosemary HollickAbstract:BACKGROUND Injection drug use (IDU) is a known, but infrequent risk factor on Candidemia; however, the opioid epidemic and increases in IDU may be changing the epidemiology of Candidemia. METHODS Active population-based surveillance for Candidemia was conducted in selected US counties. Cases of Candidemia were categorized as IDU cases if IDU was indicated in the medical records in the 12 months prior to the date of initial culture. RESULTS During 2017, 1191 Candidemia cases were identified in patients aged >12 years (incidence: 6.9 per 100 000 population); 128 (10.7%) had IDU history, and this proportion was especially high (34.6%) in patients with Candidemia aged 19-44. Patients with Candidemia and IDU history were younger than those without (median age, 35 vs 63 years; P < .001). Candidemia cases involving recent IDU were less likely to have typical risk factors including malignancy (7.0% vs 29.4%; relative risk [RR], 0.2 [95% confidence interval {CI}, .1-.5]), abdominal surgery (3.9% vs 17.5%; RR, 0.2 [95% CI, .09-.5]), and total parenteral nutrition (3.9% vs 22.5%; RR, 0.2 [95% CI, .07-.4]). Candidemia cases with IDU occurred more commonly in smokers (68.8% vs 18.5%; RR, 3.7 [95% CI, 3.1-4.4]), those with hepatitis C (54.7% vs 6.4%; RR, 8.5 [95% CI, 6.5-11.3]), and in people who were homeless (13.3% vs 0.8%; RR, 15.7 [95% CI, 7.1-34.5]). CONCLUSIONS Clinicians should consider injection drug use as a risk factor in patients with Candidemia who lack typical Candidemia risk factors, especially in those with who are 19-44 years of age and have community-associated Candidemia.
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the changing epidemiology of Candidemia in the united states injection drug use as an increasingly common risk factor active surveillance in selected sites united states 2014 17
Clinical Infectious Diseases, 2019Co-Authors: Alexia Y Zhang, Sarah Shrum, Sabrina Williams, Sarah Petnic, Joelle Nadle, Helen Johnston, Devra Barter, Brittany Vonbank, Lindsay Bonner, Rosemary HollickAbstract:BACKGROUND: Injection drug use (IDU) is a known, but infrequent risk factor on Candidemia, however, the opioid epidemic and increases in IDU may be changing the epidemiology of Candidemia. METHODS: Active population-based surveillance for Candidemia was conducted in selected US counties. Cases of Candidemia were categorized as IDU cases if IDU was indicated in the medical records in the 12 months prior to the date of initial culture. RESULTS: During 2017, 1191 Candidemia cases were identified in patients over the age of 12 years (incidence: 6.9 per 100,000 population); 128 (10.7%) had IDU history and this proportion was especially high (34.6%) in patients with Candidemia aged 19-44 years. Candidemia patients with IDU history were younger than those without (median age: 35 vs 63 years, p<0.001). Candidemia cases involving recent IDU were less likely to have typical risk factors including malignancy (7.0% vs 29.4%, Relative Risk (RR): 0.2; 95% Confidence Interval (CI): 0.1-0.5), abdominal surgery (3.9% vs 17.5%, RR: 0.2, CI: 0.09-0.5), and total parenteral nutrition (3.9% vs 22.5%, RR: 0.2, CI: 0.07-0.4). Candidemia cases with IDU occurred more commonly in smokers (68.8% vs 18.5%, RR: 3.7, CI: 3.1-4.4), those with hepatitis C (54.7% vs 6.4%, RR: 8.5, CI: 6.5-11.3), and in people who were homeless (13.3% vs 0.8%, RR: 15.7; CI: 7.1-34.5). CONCLUSION: Clinicians should consider screening for Candidemia in people who inject drugs and IDU in patients with Candidemia who lack typical Candidemia risk factors, especially in those with who are 19-44 years, and have community-associated Candidemia.
Marcio Nucci - One of the best experts on this subject based on the ideXlab platform.
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Epidemiology of Candidemia in Latin America: A Laboratory-Based Survey
PloS one, 2013Co-Authors: Marcio Nucci, Iris Nora Tiraboschi, María Elena Santolaya, Flavio De Queiroz Telles, Jeannete Zurita, Jorge E. Cortes, Manuel Guzman-blanco, Tito Alvarado Matute, Luis Thompson, José Sifuentes-osornioAbstract:Background The epidemiology of Candidemia varies depending on the geographic region. Little is known about the epidemiology of Candidemia in Latin America. Methods We conducted a 24-month laboratory-based survey of Candidemia in 20 centers of seven Latin American countries. Incidence rates were calculated and the epidemiology of Candidemia was characterized. Results Among 672 episodes of Candidemia, 297 (44.2%) occurred in children (23.7% younger than 1 year), 36.2% in adults between 19 and 60 years old and 19.6% in elderly patients. The overall incidence was 1.18 cases per 1,000 admissions, and varied across countries, with the highest incidence in Colombia and the lowest in Chile. Candida albicans (37.6%), C. parapsilosis (26.5%) and C. tropicalis (17.6%) were the leading agents, with great variability in species distribution in the different countries. Most isolates were highly susceptible to fluconazole, voriconazole, amphotericin B and anidulafungin. Fluconazole was the most frequent agent used as primary treatment (65.8%), and the overall 30-day survival was 59.3%. Conclusions This first large epidemiologic study of Candidemia in Latin America showed a high incidence of Candidemia, high percentage of children, typical species distribution, with C. albicans, C. parapsilosis and C. tropicalis accounting for the majority of episodes, and low resistance rates.
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Persistent Candidemia: Causes and Investigations
Current Fungal Infection Reports, 2011Co-Authors: Marcio NucciAbstract:Persistent Candidemia refers to the continued isolation of the same Candida species in the blood of a candidemic patient. Its incidence and clinical consequences are not well understood because of the lack of a homogeneous definition for persistent Candidemia and the absence of prospective studies in which blood cultures were performed at prespecified times. Data from randomized clinical trials indicate that between 8% and 15% of candidemic patients have persistently positive blood cultures at the end of treatment, and the few studies that have attempted to evaluate the impact of persistent Candidemia on outcomes have lacked appropriate analysis to conclude whether persistent Candidemia is associated with worse outcome. On the other hand, assuming that it represents therapeutic failure, major causes for persistent Candidemia include host factors (probably the most important), drug resistance, low serum levels of drugs, endovascular infection, deep-tissue abscesses, and infection associated with prosthetic material.
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early removal of central venous catheter in patients with Candidemia does not improve outcome analysis of 842 patients from 2 randomized clinical trials
Clinical Infectious Diseases, 2010Co-Authors: Marcio Nucci, Elias Anaissie, Robert F Betts, B Dupont, Donald N Buell, Laura L Kovanda, Olivier LortholaryAbstract:Background Patients with Candidemia frequently have a central venous catheter (CVC) in place, and its early removal is considered the standard of care. Methods We performed a subgroup analysis of 2 phase III, multicenter, double-blind, randomized, controlled trials of Candidemia to examine the effects of early CVC removal (within 24 or 48 h after treatment initiation) on the outcomes of 842 patients with Candidemia. Inclusion criteria were Candidemia, age >16 years, CVC at diagnosis, and receipt of 1 dose of the study drug. Six outcomes were evaluated: treatment success, rates of persistent and recurrent Candidemia, time to mycological eradication, and survival at 28 and 42 days. Univariate and multivariate analyses were performed, controlling for potential confounders. Results In univariate analysis, early CVC removal did not improve time to mycological eradication or rates of persistent or recurrent Candidemia but was associated with better treatment success and survival. These benefits were lost in multivariate analysis, which failed to show any beneficial effect of early CVC removal on all 6 outcomes and identified Acute Physiology and Chronic Health Evaluation II score, older age, and persistent neutropenia as the most significant variables. Our findings were consistent across all outcomes and time points (removal within 24 or 48 h and survival at 28 and 42 days). The median time to eradication of Candidemia was similar between the 2 study groups. Conclusions In this cohort of 842 adults with Candidemia followed up prospectively, early CVC removal was not associated with any clinical benefit. These findings suggest an evidence-based re-evaluation of current treatment recommendations.
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Candidemia em hospital terciário do nordeste do Brasil
Revista da Sociedade Brasileira de Medicina Tropical, 2008Co-Authors: Sylvia Lemos Hinrichsen, Arnaldo Lopes Colombo, Marcio Nucci, Érika Falcão, Tatiana De Aguiar Santos Vilella, Líbia Cristina Rocha Vilela Moura, Leandro Chaves Rêgo, Conceição Lira, Luciano AlmeidaAbstract:We conducted a prospective, observational, laboratory-based study on Candidemia to investigate the incidence of Candidemia, species distribution and clinical conditions between September 2003 and March 2004 in a private tertiary hospital in Recife, northeastern Brazil. Cases of Candidemia were defined as occurrences of isolation of Candida spp from blood cultures. The incidence rate was calculated per 1,000 admissions. A total of 5,532 patients were admitted to the hospital during the study period, and 1,745 blood cultures were processed. Twenty-one episodes of Candidemia were observed in 18 patients. The incidence rate of Candidemia was 3.9 episodes per 1,000 admissions. Non-albicans species accounted for more than 50% of the cases, and Candida parapsilosis (33%) and Candida tropicalis (24%) predominated. Eleven (61%) patients died. The incidence of Candidemia was higher than that observed in a Brazilian multicenter study. Candidemia was caused predominantly by non-albicans species.
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Candidemia due to candida tropicalis clinical epidemiologic and microbiologic characteristics of 188 episodes occurring in tertiary care hospitals
Diagnostic Microbiology and Infectious Disease, 2007Co-Authors: Marcio Nucci, Arnaldo Lopes ColomboAbstract:Candida tropicalis is the 2nd most frequent agent of Candidemia in Brazil (20–24%). We attempted to characterize the epidemiology, microbiology, and outcome of Candidemia due to C. tropicalis by comparing patients with Candidemia due to C. tropicalis with those with Candidemia due to Candida albicans. Among the 924 episodes of Candidemia, 188 (20%) were caused by C. tropicalis. These cases were compared with 384 Candidemias due to C. albicans. C. tropicalis was the 2nd most frequent species in adults (21.6%) and elderly patients (23.2%), and 3rd in neonates (11.9%) and children (18.5%). Cancer was the most frequent underlying disease, and in adults and elderly patients, diabetes was the 2nd most frequent underlying disease. The only difference between C. tropicalis and C. albicans Candidemia was a higher proportion of neutropenic patients in C. tropicalis Candidemia. C. tropicalis is a leading cause of Candidemia in Brazil, and its epidemiology is similar to that of C. albicans.
Alexia Y Zhang - One of the best experts on this subject based on the ideXlab platform.
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the changing epidemiology of Candidemia in the united states injection drug use as an increasingly common risk factor active surveillance in selected sites united states 2014 2017
Clinical Infectious Diseases, 2020Co-Authors: Alexia Y Zhang, Sarah Shrum, Sabrina Williams, Sarah Petnic, Joelle Nadle, Helen Johnston, Devra Barter, Brittany Vonbank, Lindsay Bonner, Rosemary HollickAbstract:BACKGROUND Injection drug use (IDU) is a known, but infrequent risk factor on Candidemia; however, the opioid epidemic and increases in IDU may be changing the epidemiology of Candidemia. METHODS Active population-based surveillance for Candidemia was conducted in selected US counties. Cases of Candidemia were categorized as IDU cases if IDU was indicated in the medical records in the 12 months prior to the date of initial culture. RESULTS During 2017, 1191 Candidemia cases were identified in patients aged >12 years (incidence: 6.9 per 100 000 population); 128 (10.7%) had IDU history, and this proportion was especially high (34.6%) in patients with Candidemia aged 19-44. Patients with Candidemia and IDU history were younger than those without (median age, 35 vs 63 years; P < .001). Candidemia cases involving recent IDU were less likely to have typical risk factors including malignancy (7.0% vs 29.4%; relative risk [RR], 0.2 [95% confidence interval {CI}, .1-.5]), abdominal surgery (3.9% vs 17.5%; RR, 0.2 [95% CI, .09-.5]), and total parenteral nutrition (3.9% vs 22.5%; RR, 0.2 [95% CI, .07-.4]). Candidemia cases with IDU occurred more commonly in smokers (68.8% vs 18.5%; RR, 3.7 [95% CI, 3.1-4.4]), those with hepatitis C (54.7% vs 6.4%; RR, 8.5 [95% CI, 6.5-11.3]), and in people who were homeless (13.3% vs 0.8%; RR, 15.7 [95% CI, 7.1-34.5]). CONCLUSIONS Clinicians should consider injection drug use as a risk factor in patients with Candidemia who lack typical Candidemia risk factors, especially in those with who are 19-44 years of age and have community-associated Candidemia.
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the changing epidemiology of Candidemia in the united states injection drug use as an increasingly common risk factor active surveillance in selected sites united states 2014 17
Clinical Infectious Diseases, 2019Co-Authors: Alexia Y Zhang, Sarah Shrum, Sabrina Williams, Sarah Petnic, Joelle Nadle, Helen Johnston, Devra Barter, Brittany Vonbank, Lindsay Bonner, Rosemary HollickAbstract:BACKGROUND: Injection drug use (IDU) is a known, but infrequent risk factor on Candidemia, however, the opioid epidemic and increases in IDU may be changing the epidemiology of Candidemia. METHODS: Active population-based surveillance for Candidemia was conducted in selected US counties. Cases of Candidemia were categorized as IDU cases if IDU was indicated in the medical records in the 12 months prior to the date of initial culture. RESULTS: During 2017, 1191 Candidemia cases were identified in patients over the age of 12 years (incidence: 6.9 per 100,000 population); 128 (10.7%) had IDU history and this proportion was especially high (34.6%) in patients with Candidemia aged 19-44 years. Candidemia patients with IDU history were younger than those without (median age: 35 vs 63 years, p<0.001). Candidemia cases involving recent IDU were less likely to have typical risk factors including malignancy (7.0% vs 29.4%, Relative Risk (RR): 0.2; 95% Confidence Interval (CI): 0.1-0.5), abdominal surgery (3.9% vs 17.5%, RR: 0.2, CI: 0.09-0.5), and total parenteral nutrition (3.9% vs 22.5%, RR: 0.2, CI: 0.07-0.4). Candidemia cases with IDU occurred more commonly in smokers (68.8% vs 18.5%, RR: 3.7, CI: 3.1-4.4), those with hepatitis C (54.7% vs 6.4%, RR: 8.5, CI: 6.5-11.3), and in people who were homeless (13.3% vs 0.8%, RR: 15.7; CI: 7.1-34.5). CONCLUSION: Clinicians should consider screening for Candidemia in people who inject drugs and IDU in patients with Candidemia who lack typical Candidemia risk factors, especially in those with who are 19-44 years, and have community-associated Candidemia.
Devra Barter - One of the best experts on this subject based on the ideXlab platform.
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the changing epidemiology of Candidemia in the united states injection drug use as an increasingly common risk factor active surveillance in selected sites united states 2014 2017
Clinical Infectious Diseases, 2020Co-Authors: Alexia Y Zhang, Sarah Shrum, Sabrina Williams, Sarah Petnic, Joelle Nadle, Helen Johnston, Devra Barter, Brittany Vonbank, Lindsay Bonner, Rosemary HollickAbstract:BACKGROUND Injection drug use (IDU) is a known, but infrequent risk factor on Candidemia; however, the opioid epidemic and increases in IDU may be changing the epidemiology of Candidemia. METHODS Active population-based surveillance for Candidemia was conducted in selected US counties. Cases of Candidemia were categorized as IDU cases if IDU was indicated in the medical records in the 12 months prior to the date of initial culture. RESULTS During 2017, 1191 Candidemia cases were identified in patients aged >12 years (incidence: 6.9 per 100 000 population); 128 (10.7%) had IDU history, and this proportion was especially high (34.6%) in patients with Candidemia aged 19-44. Patients with Candidemia and IDU history were younger than those without (median age, 35 vs 63 years; P < .001). Candidemia cases involving recent IDU were less likely to have typical risk factors including malignancy (7.0% vs 29.4%; relative risk [RR], 0.2 [95% confidence interval {CI}, .1-.5]), abdominal surgery (3.9% vs 17.5%; RR, 0.2 [95% CI, .09-.5]), and total parenteral nutrition (3.9% vs 22.5%; RR, 0.2 [95% CI, .07-.4]). Candidemia cases with IDU occurred more commonly in smokers (68.8% vs 18.5%; RR, 3.7 [95% CI, 3.1-4.4]), those with hepatitis C (54.7% vs 6.4%; RR, 8.5 [95% CI, 6.5-11.3]), and in people who were homeless (13.3% vs 0.8%; RR, 15.7 [95% CI, 7.1-34.5]). CONCLUSIONS Clinicians should consider injection drug use as a risk factor in patients with Candidemia who lack typical Candidemia risk factors, especially in those with who are 19-44 years of age and have community-associated Candidemia.
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the changing epidemiology of Candidemia in the united states injection drug use as an increasingly common risk factor active surveillance in selected sites united states 2014 17
Clinical Infectious Diseases, 2019Co-Authors: Alexia Y Zhang, Sarah Shrum, Sabrina Williams, Sarah Petnic, Joelle Nadle, Helen Johnston, Devra Barter, Brittany Vonbank, Lindsay Bonner, Rosemary HollickAbstract:BACKGROUND: Injection drug use (IDU) is a known, but infrequent risk factor on Candidemia, however, the opioid epidemic and increases in IDU may be changing the epidemiology of Candidemia. METHODS: Active population-based surveillance for Candidemia was conducted in selected US counties. Cases of Candidemia were categorized as IDU cases if IDU was indicated in the medical records in the 12 months prior to the date of initial culture. RESULTS: During 2017, 1191 Candidemia cases were identified in patients over the age of 12 years (incidence: 6.9 per 100,000 population); 128 (10.7%) had IDU history and this proportion was especially high (34.6%) in patients with Candidemia aged 19-44 years. Candidemia patients with IDU history were younger than those without (median age: 35 vs 63 years, p<0.001). Candidemia cases involving recent IDU were less likely to have typical risk factors including malignancy (7.0% vs 29.4%, Relative Risk (RR): 0.2; 95% Confidence Interval (CI): 0.1-0.5), abdominal surgery (3.9% vs 17.5%, RR: 0.2, CI: 0.09-0.5), and total parenteral nutrition (3.9% vs 22.5%, RR: 0.2, CI: 0.07-0.4). Candidemia cases with IDU occurred more commonly in smokers (68.8% vs 18.5%, RR: 3.7, CI: 3.1-4.4), those with hepatitis C (54.7% vs 6.4%, RR: 8.5, CI: 6.5-11.3), and in people who were homeless (13.3% vs 0.8%, RR: 15.7; CI: 7.1-34.5). CONCLUSION: Clinicians should consider screening for Candidemia in people who inject drugs and IDU in patients with Candidemia who lack typical Candidemia risk factors, especially in those with who are 19-44 years, and have community-associated Candidemia.
