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Master Thesis

Impact of adherence with ESCMID recommendations on mortality in patients with candidemia: a retrospective cohort study

Abstract : The ESCMID published recommendations on the management of candidemia in 2012. The adherence with these recommendations and its impact on candidemia outcome are not clearly known. The objective of this study was to evaluate factors of adherence with these recommendations an the impact on mortality of ESCMID adherence in a French tertiary-care, University hospital. We performed a retrospective cohort study in the university hospital of Caen and the comprehensive cancer center François Baclesse of Caen. All patients with at least one positive blood culture (BC) for Candida spp. between January 2013 and December 2019 were included. Patients under 18 years old, patient with isolated blood culture with C. parapsilosis, patient in palliative care or who died within 24 hours the diagnosis of candidemia were excluded. An adherent case was defined as candidemia for which the treatment fulfilled a bundle of defined criteria. During the study period, 165 episodes of candidemia were included. Recommendations were fully implemented in 44 cases (26.7%). Funduscopic examination were missing in 45.2% as well as echocardiography in 31.2% and daily blood culture in 26.7%. After achieving a propensity score, mortality was significantly higher in the non-adherent group than in the group adhering to ESCMID recommendations. In our study, adherence with ESCMID recommendations was low. Adherence with main criteria of candidemia management increased survival showing the importance of the recommendations adherence. More efforts to implement recommendations are warranted.
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https://dumas.ccsd.cnrs.fr/dumas-03546155
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Submitted on : Thursday, January 27, 2022 - 5:42:09 PM
Last modification on : Wednesday, February 23, 2022 - 3:28:26 AM

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  • HAL Id : dumas-03546155, version 1

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Charles Maurille. Impact of adherence with ESCMID recommendations on mortality in patients with candidemia: a retrospective cohort study. Human health and pathology. 2021. ⟨dumas-03546155⟩

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