Journal article
Impact of Infectious Disease Consultation in Patients With Candidemia: A Retrospective Study, Systematic Literature Review, and Meta-analysis
Open forum infectious diseases, Vol.7(9), ofaa270
09/01/2020
DOI: 10.1093/ofid/ofaa270
PMID: 32904995
Abstract
Background
Morbidity and mortality from candidemia remain unacceptably high. While infectious disease consultation (IDC) is known to lower the mortality from Staphylococcus aureus bacteremia, little is known about the impact of IDC in candidemia.
Methods
We conducted a retrospective observational cohort study of candidemia patients at a large tertiary care hospital between 2015 and 2019. The crude mortality rate was compared between those with IDC and without IDC. Then, we systematically searched 5 databases through February 2020 and performed a meta-analysis of the impact of IDC on the mortality of patients with candidemia.
Results
A total of 151 patients met the inclusion criteria, 129 (85%) of whom received IDC. Thirty-day and 90-day mortality rates were significantly lower in the IDC group (18% vs 50%; P = .002; 23% vs 50%; P = .0022, respectively). A systematic literature review returned 216 reports, of which 13 studies including the present report fulfilled the inclusion criteria. Among the 13 studies with a total of 3582 patients, IDC was performed in 50% of patients. Overall mortality was 38.2% with a significant difference in favor of the IDC group (28.4% vs 47.6%), with a pooled relative risk of 0.41 (95% CI, 0.35–0.49). Ophthalmology referral, echocardiogram, and central line removal were performed more frequently among patients receiving IDC.
Conclusions
This study is the first systematic literature review and meta-analysis to evaluate the association between IDC and candidemia mortality. IDC was associated with significantly lower mortality and should be considered in all patients with candidemia.
Details
- Title: Subtitle
- Impact of Infectious Disease Consultation in Patients With Candidemia: A Retrospective Study, Systematic Literature Review, and Meta-analysis
- Creators
- Takaaki Kobayashi - University of IowaAlexandre R Marra - University of Iowa, Infectious DiseasesMarin L Schweizer - University of Iowa, General Internal MedicinePatrick Ten Eyck - University of Iowa, Institute for Clinical and Translational ScienceChaorong Wu - University of IowaMohammed Alzunitan - University of Iowa, Infectious DiseasesJorge L Salinas - University of Iowa, Infectious DiseasesMarc Siegel - George Washington UniversityDimitrios Farmakiotis - Brown UniversityPaul G Auwaerter - Johns Hopkins UniversityHeather S Healy - University of Iowa, Hardin LibraryDaniel J Diekema - University of Iowa, Infectious Diseases
- Resource Type
- Journal article
- Publication Details
- Open forum infectious diseases, Vol.7(9), ofaa270
- DOI
- 10.1093/ofid/ofaa270
- PMID
- 32904995
- NLM abbreviation
- Open Forum Infect Dis
- ISSN
- 2328-8957
- eISSN
- 2328-8957
- Publisher
- Oxford University Press
- Grant note
- name: National Institutes of Health Clinical and Translational Science, award: UL1TR002537
- Language
- English
- Date published
- 09/01/2020
- Academic Unit
- Infectious Diseases; Epidemiology; Pathology; Biostatistics; Hardin Library; Internal Medicine
- Record Identifier
- 9983993017402771
Metrics
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