Lars Jørgen Østergaard

High incidence of candidaemia in a nationwide cohort: Underlying diseases, risk factors and mortality

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • K R Lausch
  • ,
  • M Søgaard, Aalborg University, Denmark
  • F S Rosenvinge, Dpt. of Clinical Microbiology, Odense University Hospital, Odense, Denmark; Dpt. of Clinical Microbiology, Lillebaelt Hospital, Denmark.
  • ,
  • H K Johansen, University of Copenhagen, Denmark
  • T Boysen, Dpt. of Clinical Microbiology, Hvidovre Hospital, Hvidovre, Denmark.
  • ,
  • B Røder, Dpt. of Clinical Microbiology, Slagelse Sygehus, Slagelse, Denmark.
  • ,
  • K L Mortensen
  • L Nielsen, University of Copenhagen, Denmark
  • L Lemming
  • ,
  • B Olesen, University of Copenhagen, Denmark
  • C Leitz, Dpt. of Clinical Microbiology, Viborg Regionshospital, Viborg, Denmark.
  • ,
  • L Kristensen
  • E Dzajic, Dpt. of Clinical Microbiology, Sydvestjysk Sygehus, Denmark.
  • ,
  • L Østergaard
  • H C Schønheyder
  • M C Arendrup, Dpt. of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark; Unit of Mycology, Statens Serum Institute, Copenhagen, Denmark; Dpt. of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

BACKGROUND: Denmark has a high incidence rate of candidaemia. A Nordic study suggested a higher Danish prevalence of haematological malignancies as an underlying reason. This nationwide study ascertained clinical characteristics of Danish candidaemia patients and investigated potential factors contributing to the high incidence and mortality.

METHODS: Microbiological and clinical data for candidaemia patients in 2010-2011 were retrieved. 30-day mortality was estimated by hazard ratios (HR) with 95% confidence intervals (CI, Cox regression).

RESULTS: Data were available for 912/973 candidaemia episodes (93.7%). Intensive care unit (ICU) held the largest share of patients (43.2%). Prevalent host factors were multi-morbidity (≥2 underlying diseases, 74.2%) and gastrointestinal disease (52.5%). Haematological disease was infrequent (7.8%). Risk factors included antibiotic exposure (90.5%), CVC (71.9%) and Candida colonisation (66.7%). 30-day mortality was 43.4%, and 53.6% in ICU. Mortality was lower for patients with recent abdominal surgery (HR 0.70, 95% CI: 0.54-0.92).

CONCLUSION: A substantial prevalence of multi-morbidity and a high 30-day mortality was found. We hypothesise, that an increasing population of severely ill patients with prolonged supportive treatment and microbiological testing may in part explain the high candidaemia incidence in Denmark. Nationwide studies are warranted to clarify this issue.

Original languageEnglish
JournalInternational Journal of Infectious Diseases
Volume76
Pages (from-to)58-63
Number of pages6
ISSN1201-9712
DOIs
Publication statusPublished - 2018

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