Table 2.
Comparison of patients with candidemia who were managed according to the comprehensive care bundle or not (controls)
| Variables | Total population (n = 109) |
Pre-intervention group (n = 56) |
Post-intervention group (n = 53) |
p value* |
|---|---|---|---|---|
| Age (years), mean ± SD | 67.2 ± 13.9 | 66.6 ± 13.5 | 67.8 ± 14.4 | 0.67 |
| Male, n (%) | 73 (67.0) | 37 (66.1) | 36 (67.9) | 1 |
| Department, n (%) | ||||
| Medical ward | 38 (34.9) | 17 (30.4) | 21 (39.6) | 0.32 |
| Surgical ward | 36 (33.0) | 23 (41.1) | 13 (24.5) | 0.07 |
| ICU stay | 23 (21.1) | 10 (17.9) | 13 (24.5) | 0.48 |
| Oncology-hematology ward | 12 (11.0) | 6 (10.7) | 6 (11.3) | 1 |
| Underlying disease, n (%) | ||||
| Solid tumor | 60 (55.0) | 31 (55.4) | 29 (54.7) | 1 |
| Gastrointestinal disease | 44 (40.7) | 25 (45.5) | 19 (35.8) | 0.33 |
| Diabetes mellitus | 26 (23.9) | 12 (21.4) | 14 (26.4) | 0.65 |
| Neurologic disease | 26 (23.9) | 12 (21.4) | 14 (26.4) | 0.65 |
| Cardiovascular disease | 25 (22.9) | 13 (23.2) | 12 (22.6) | 1 |
| Liver disease | 15 (13.9) | 10 (18.2) | 5 (9.4) | 0.26 |
| Hematologic malignancy | 6 (5.5) | 2 (3.6) | 4 (7.5) | 0.43 |
| Charlson comorbidity index, mean ± SD | 3.6 ± 2.5 | 3.6 ± 2.6 | 3.6 ± 2.5 | 0.93 |
| Risk factor, n (%) | ||||
| Central venous catheter | 86 (78.9) | 48 (85.7) | 38 (71.7) | 0.10 |
| Total parenteral nutrition | 70 (64.2) | 35 (62.5) | 35 (66.0) | 0.84 |
| Previous abdominal surgery | 45 (41.3) | 26 (46.4) | 19 (35.8) | 0.33 |
| Corticosteroids | 34 (31.2) | 16 (28.6) | 18 (34.0) | 0.67 |
| Previous antifungals | 31 (28.4) | 15 (26.8) | 16 (30.2) | 0.83 |
| Neutropenia | 8 (7.3) | 5 (8.9) | 3 (5.7) | 0.71 |
| Immunosuppressive therapy | 8 (7.3) | 3 (5.4) | 5 (9.4) | 0.48 |
| Pitt score, median (IQR) | 0 (0–2) | 0 (0–2) | 0 (0–2) | 0.64 |
| Time between hospitalization and candidemia onset, median (IQR) | 23.0 (9.0–39.0) | 22.0 (6.5–38.5) | 23.0 (12.0–45.0) | 0.55 |
| Clinical manifestation, n (%) | ||||
| Sepsis | 40 (36.7) | 23 (41.1) | 17 (32.1) | 0.42 |
| Severe sepsis | 31 (28.4) | 20 (35.7) | 11 (20.8) | 0.09 |
| Septic shock | 12 (11.0) | 4 (7.1) | 8 (15.1) | 0.22 |
| Candida species, n (%) | ||||
| C. albicans | 56 (51.4) | 25 (44.6) | 31 (58.5) | 0.18 |
| C. parapsilosis | 27 (24.8) | 14 (25.0) | 13 (24.5) | 1 |
| C. glabrata | 15 (13.2) | 8 (14.3) | 7 (13.2) | 1 |
| C. krusei | 6 (5.5) | 4 (7.1) | 2 (3.8) | 0.67 |
| C. tropicalis | 4 (3.7) | 2 (3.6) | 2 (3.8) | 1 |
| Other Candida speciesa | 3 (2.8) | 3 (5.4) | 0 | 0.24 |
| Source, n (%) | ||||
| Central venous catheter | 65 (59.6) | 33 (58.9) | 32 (60.4) | 1 |
| Intra-abdominal | 18 (16.5) | 12 (21.4) | 6 (11.3) | 0.20 |
| Primary | 13 (11.9) | 6 (10.7) | 7 (13.2) | 0.77 |
| Urinary tract | 7 (6.4) | 4 (7.1) | 3 (5.7) | 1 |
| Othersb | 6 (5.5) | 1 (1.8) | 5 (9.4) | 0.10 |
| Initial antifungal therapy, n (%) | ||||
| Fluconazole | 74 (67.9) | 38 (67.8) | 36 (67.9) | 1 |
| Echinocandins | 29 (26.6) | 15 (26.7) | 14 (26.4) | 1 |
| Liposomal amphotericin B | 6 (5.5) | 3 (5.4) | 3 (5.7) | 1 |
| ICU admission, n (%) | 10 (9.2) | 5 (8.9) | 5 (9.4) | 1 |
| Length of hospital stay (days), median (IQR) | 50.0 (31.0–88.5) | 46.5 (22–86.7) | 51 (37–97.5) | 0.96 |
ICU intensive care units
aOther Candida species include: 1 C. lusitaniae, 1 C. dublinensis and 1 C. incospicua
bOther sources include: 1 chorioamnionitis, 2 peripheral catather; 2 infective endocarditis, 1 infection from prosthesis
*P values < 0.05 are shown in bold