RT Journal Article
T1 Factors associated with the development of septic shock in patients with candidemia: a post hoc analysis from two prospective cohorts.
A1 Bassetti, Matteo
A1 Vena, Antonio
A1 Meroi, Marco
A1 Cardozo, Celia
A1 Cuervo, Guillermo
A1 Giacobbe, Daniele Roberto
A1 Salavert, Miguel
A1 Merino, Paloma
A1 Gioia, Francesca
A1 Fernández-Ruiz, Mario
A1 López-Cortés, Luis Eduardo
A1 Almirante, Benito
A1 Escolà-Vergé, Laura
A1 Montejo, Miguel
A1 Aguilar-Guisado, Manuela
A1 Puerta-Alcalde, Pedro
A1 Tasias, Mariona
A1 Ruiz-Gaitán, Alba
A1 González, Fernando
A1 Puig-Asensio, Mireia
A1 Marco, Francesc
A1 Pemán, Javier
A1 Fortún, Jesus
A1 Aguado, Jose Maria
A1 Soriano, Alejandro
A1 Carratalá, Jordi
A1 Garcia-Vidal, Carolina
A1 Valerio, Maricela
A1 Sartor, Assunta
A1 Bouza, Emilio
A1 Muñoz, Patricia
K1 Candidemia
K1 Intra-abdominal candidiasis
K1 Risk factors
K1 Septic shock
AB Almost one third of the patients with candidemia develop septic shock. The understanding why some patients do and others do not develop septic shock is very limited. The objective of this study was to identify variables associated with septic shock development in a large population of patients with candidemia. A post hoc analysis was performed on two prospective, multicenter cohort of patients with candidemia from 12 hospitals in Spain and Italy. All episodes occurring from September 2016 to February 2018 were analyzed to assess variables associated with septic shock development defined according to The Third International Consensus Definition for Sepsis and Septic Shock (Sepsis-3). Of 317 candidemic patients, 99 (31.2%) presented septic shock attributable to candidemia. Multivariate logistic regression analysis identifies the following factors associated with septic shock development: age > 50 years (OR 2.57, 95% CI 1.03-6.41, p = 0.04), abdominal source of the infection (OR 2.18, 95% CI 1.04-4.55, p = 0.04), and admission to a general ward at the time of candidemia onset (OR 0.21, 95% CI, 0.12-0.44, p = 0.001). Septic shock development was independently associated with a greater risk of 30-day mortality (OR 2.14, 95% CI 1.08-4.24, p = 0.02). Age and abdominal source of the infection are the most important factors significantly associated with the development of septic shock in patients with candidemia. Our findings suggest that host factors and source of the infection may be more important for development of septic shock than intrinsic virulence factors of organisms.
YR 2020
FD 2020-03-26
LK http://hdl.handle.net/10668/15290
UL http://hdl.handle.net/10668/15290
LA en
DS RISalud
RD Apr 7, 2025