Abstract
Candida infective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens for Candida infective endocarditis. This prospective cohort study was based on 70 cases of Candida infective endocarditis from the International Collaboration on Endocarditis (ICE)-Prospective Cohort Study and ICE-Plus databases collected between 2000 and 2010. The majority of infections were acquired nosocomially (67%). Congestive heart failure (24%), prosthetic heart valve (46%), and previous infective endocarditis (26%) were common comorbidities. Overall mortality was high, with 36% mortality in the hospital and 59% at 1 year. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality. Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy. Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion, Candida infective endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis.
| Original language | English |
|---|---|
| Pages (from-to) | 2365-2373 |
| Number of pages | 9 |
| Journal | Antimicrobial Agents and Chemotherapy |
| Volume | 59 |
| Issue number | 4 |
| DOIs | |
| State | Published - 1 Apr 2015 |
| Externally published | Yes |
Bibliographical note
Publisher Copyright:Copyright © 2015, American Society for Microbiology.
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In: Antimicrobial Agents and Chemotherapy, Vol. 59, No. 4, 01.04.2015, p. 2365-2373.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Candida infective endocarditis
T2 - An observational cohort study with a focus on therapy
AU - Arnold, Christopher J.
AU - Johnson, Melissa
AU - Bayer, Arnold S.
AU - Bradley, Suzanne
AU - Giannitsioti, Efthymia
AU - Miró, José M.
AU - Tornos, Pilar
AU - Tattevin, Pierre
AU - Strahilevitz, Jacob
AU - Spelman, Denis
AU - Athan, Eugene
AU - Nacinovich, Francisco
AU - Fortes, Claudio Q.
AU - Lamas, Cristiane
AU - Barsic, Bruno
AU - Fernández-Hidalgo, Nuria
AU - Muñoz, Patricia
AU - Chu, Vivian H.
AU - Clara, Liliana
AU - Sanchez, Marisa
AU - Casabé, José
AU - Cortes, Claudia
AU - Oses, Pablo Fernandez
AU - Ronderos, Ricardo
AU - Sucari, Adriana
AU - Thierer, Jorge
AU - Altclas, Javier
AU - Kogan, Silvia
AU - Harris, Owen
AU - Kennedy, Karina
AU - Tan, Ren
AU - Gordon, David
AU - Papanicolas, Lito
AU - Korman, Tony
AU - Kotsanas, Despina
AU - Dever, Robyn
AU - Jones, Phillip
AU - Konecny, Pam
AU - Lawrence, Richard
AU - Rees, David
AU - Ryan, Suzanne
AU - Feneley, Michael P.
AU - Harkness, John
AU - Post, Jeffrey
AU - Reinbott, Porl
AU - Gattringer, Rainer
AU - Wiesbauer, Franz
AU - Andrade, Adriana Ribas
AU - De Brito, Ana Cláudia Passos
AU - Guimarães, Armenio Costa
AU - Grinberg, Max
AU - Mansur, Alfredo José
AU - Siciliano, Rinaldo Focaccia
AU - Strabelli, Tania Mara Varejao
AU - Vieira, Marcelo Luiz Campos
AU - De Medeiros Tranchesi, Regina Aparecida
AU - Paiva, Marcelo Goulart
AU - Fortes, Claudio Querido
AU - De Oliveira Ramos, Auristela
AU - Weksler, Clara
AU - Ferraiuoli, Giovanna
AU - Golebiovski, Wilma
AU - Karlowsky, James A.
AU - Keynan, Yoav
AU - Morris, Andrew M.
AU - Rubinstein, Ethan
AU - Jones, Sandra Braun
AU - Garcia, Patricia
AU - Cereceda, M.
AU - Fica, Alberto
AU - Mella, Rodrigo Montagna
AU - Fernandez, Ricardo
AU - Franco, Liliana
AU - Gonzalez, Javier
AU - Jaramillo, Astrid Natalia
AU - Bukovski, Suzana
AU - Krajinovic, Vladimir
AU - Pangercic, Ana
AU - Rudez, Igor
AU - Vincelj, Josip
AU - Freiberger, Tomas
AU - Pol, Jiri
AU - Zaloudikova, Barbora
AU - Ashour, Zainab
AU - Kholy, Amani El
AU - Mishaal, Marwa
AU - Osama, Dina
AU - Rizk, Hussien
AU - Aissa, Neijla
AU - Alauzet, Corentine
AU - Alla, Francois
AU - Campagnac, Catherine
AU - Doco-Lecompte, Thanh
AU - Selton-Suty, Christine
AU - Casalta, Jean Paul
AU - Fournier, Pierre Edouard
AU - Habib, Gilbert
AU - Raoult, Didier
AU - Thuny, Franck
AU - Delahaye, Francois
AU - Delahaye, Armelle
AU - Vandenesch, Francois
AU - Donal, Erwan
AU - Donnio, Pierre Yves
AU - Flecher, Erwan
AU - Michelet, Christian
AU - Revest, Matthieu
AU - Chevalier, Florent
AU - Jeu, Antoine
AU - Rémadi, Jean Paul
AU - Rusinaru, Dan
AU - Tribouilloy, Christophe
AU - Bernard, Yvette
AU - Chirouze, Catherine
AU - Hoen, Bruno
AU - Leroy, Joel
AU - Plesiat, Patrick
AU - Naber, Christoph
AU - Neuerburg, Carl
AU - Mazaheri, Bahram
AU - Helen, Giamarellou
AU - Sofia, Athanasia
AU - Ioannis, Deliolanis
AU - Thomas, Tsaganos
AU - Mylona, Elena
AU - Paniara, Olga
AU - Papanicolaou, Konstantinos
AU - Pyros, John
AU - Skoutelis, Athanasios
AU - Sharma, Gautam
AU - Francis, Johnson
AU - Nair, Lathi
AU - Thomas, Vinod
AU - Venugopal, Krishnan
AU - Hannan, Margaret M.
AU - Hurley, John P.
AU - Cahan, Amos
AU - Gilon, Dan
AU - Israel, Sarah
AU - Korem, Maya
AU - Durante-Mangoni, Emanuele
AU - Mattucci, Irene
AU - Pinto, Daniela
AU - Agrusta, Federica
AU - Senese, Alessandra
AU - Ragone, Enrico
AU - Utili, Riccardo
AU - Cecchi, Enrico
AU - De Rosa, Francesco
AU - Forno, Davide
AU - Imazio, Massimo
AU - Trinchero, Rita
AU - Grossi, Paolo
AU - Lattanzio, Mariangela
AU - Toniolo, Antonio
AU - Goglio, Antonio
AU - Raglio, Annibale
AU - Ravasio, Veronica
AU - Rizzi, Marco
AU - Suter, Fredy
AU - Carosi, Giampiero
AU - Magri, Silvia
AU - Signorini, Liana
AU - Kanafani, Zeina
AU - Kanj, Souha S.
AU - Sharif-Yakan, Ahmad
AU - Abidin, Imran
AU - Tamin, Syahidah Syed
AU - Martínez, Eduardo Rivera
AU - Nieto, Gabriel Israel Soto
AU - Van Der Meer, Jan T.M.
AU - Chambers, Stephen
AU - Holland, David
AU - Morris, Arthur
AU - Raymond, Nigel
AU - Read, Kerry
AU - Murdoch, David R.
AU - Dragulescu, Stefan
AU - Ionac, Adina
AU - Mornos, Cristian
AU - Butkevich, O. M.
AU - Chipigina, Natalia
AU - Kirill, Ozerecky
AU - Vadim, Kulichenko
AU - Vinogradova, Tatiana
AU - Edathodu, Jameela
AU - Halim, Magid
AU - Liew, Yee Yun
AU - Tan, Ru San
AU - Lejko-Zupanc, Tatjana
AU - Logar, Mateja
AU - Mueller-Premru, Manica
AU - Commerford, Patrick
AU - Commerford, Anita
AU - Deetlefs, Eduan
AU - Hansa, Cass
AU - Ntsekhe, Mpiko
AU - Almela, Manuel
AU - Armero, Yolanda
AU - Azqueta, Manuel
AU - Castañeda, Ximena
AU - Cervera, Carlos
AU - Falces, Carlos
AU - Garcia-De-La-Maria, Cristina
AU - Fita, Guillermina
AU - Gatell, Jose M.
AU - Heras, Magda
AU - Llopis, Jaime
AU - Marco, Francesc
AU - Mestres, Carlos A.
AU - Moreno, Asuncion
AU - Ninot, Salvador
AU - Paré, Carlos
AU - Pericas, Juan M.
AU - Ramirez, Jose
AU - Rovira, Irene
AU - Sitges, Marta
AU - Anguera, Ignasi
AU - Font, Bernat
AU - Guma, Joan Raimon
AU - Bermejo, Javier
AU - Bouza, Emilio
AU - Leoni, Maria Eugenia García
AU - Robles, Jose Antonio García
AU - Ramallo, Victor González
AU - Cruz, Ana Fernández
AU - Kestler, Martha
AU - Marín, Mercedes
AU - Sellés, Manuel Martínez
AU - Abella, Hugo Rodríguez
AU - Roda, Jorge Rodríguez
AU - López, Rosa Ana
AU - Pinilla, Blanca
AU - Pinto, Ángel
AU - Valerio, Maricela
AU - Vázquez, Pilar
AU - Verde, Eduardo
AU - Almirante, Benito
AU - De Alarcón, Arístides
AU - Parra, Ricardo
AU - Alestig, Eric
AU - Johansson, Magnus
AU - Olaison, Lars
AU - Snygg-Martin, Ulrika
AU - Pachirat, Orathai
AU - Pachirat, Pimchitra
AU - Pussadhamma, Burabha
AU - Senthong, Vichai
AU - Casey, Anna
AU - Elliott, Tom
AU - Lambert, Peter
AU - Watkin, Richard
AU - Eyton, Christina
AU - Klein, John L.
AU - Kauffman, Carol
AU - Bedimo, Roger
AU - Corey, G. Ralph
AU - Crowley, Anna Lisa
AU - Douglas, Pamela
AU - Drew, Laura
AU - Fowler, Vance G.
AU - Holland, Thomas
AU - Lalani, Tahaniyat
AU - Mudrick, Daniel
AU - Samad, Zaniab
AU - Sexton, Daniel
AU - Stryjewski, Martin
AU - Wang, Andrew
AU - Woods, Christopher W.
AU - Lerakis, Stamatios
AU - Cantey, Robert
AU - Steed, Lisa
AU - Wray, Dannah
AU - Dickerman, Stuart A.
AU - Bonilla, Hector
AU - DiPersio, Joseph
AU - Salstrom, Sara Jane
AU - Baddley, John
AU - Patel, Mukesh
AU - Peterson, Gail
AU - Stancoven, Amy
AU - Levine, Donald
AU - Riddle, Jonathan
AU - Rybak, Michael
AU - Cabell, Christopher H.
AU - Baloch, Khaula
AU - Dixon, Christy C.
AU - Harding, Tina
AU - Jones-Richmond, Marian
AU - Park, Lawrence P.
AU - Sanderford, Bob
AU - Stafford, Judy
AU - Anstrom, Kevin
AU - Karchmer, A. W.
AU - Sexton, Daniel J.
AU - Durack, David T.
AU - Eykyn, Susannah
AU - Moreillon, Phillipe
AU - Sexton., Daniel J.
N1 - Publisher Copyright: Copyright © 2015, American Society for Microbiology.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Candida infective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens for Candida infective endocarditis. This prospective cohort study was based on 70 cases of Candida infective endocarditis from the International Collaboration on Endocarditis (ICE)-Prospective Cohort Study and ICE-Plus databases collected between 2000 and 2010. The majority of infections were acquired nosocomially (67%). Congestive heart failure (24%), prosthetic heart valve (46%), and previous infective endocarditis (26%) were common comorbidities. Overall mortality was high, with 36% mortality in the hospital and 59% at 1 year. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality. Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy. Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion, Candida infective endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis.
AB - Candida infective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens for Candida infective endocarditis. This prospective cohort study was based on 70 cases of Candida infective endocarditis from the International Collaboration on Endocarditis (ICE)-Prospective Cohort Study and ICE-Plus databases collected between 2000 and 2010. The majority of infections were acquired nosocomially (67%). Congestive heart failure (24%), prosthetic heart valve (46%), and previous infective endocarditis (26%) were common comorbidities. Overall mortality was high, with 36% mortality in the hospital and 59% at 1 year. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality. Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy. Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion, Candida infective endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis.
UR - http://www.scopus.com/inward/record.url?scp=84928901521&partnerID=8YFLogxK
U2 - 10.1128/AAC.04867-14
DO - 10.1128/AAC.04867-14
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 25645855
AN - SCOPUS:84928901521
SN - 0066-4804
VL - 59
SP - 2365
EP - 2373
JO - Antimicrobial Agents and Chemotherapy
JF - Antimicrobial Agents and Chemotherapy
IS - 4
ER -