Publications

Authors:

Zatta, M; Di Bella, S; Giacobbe, Dr; Del Puente, F; Merelli, M; Azzini, Am; Brugnaro, P; Vedovelli, C; Cattelan, Am; Busetti, M; Gatti, G; Bassetti, M; Luzzati, R

Title:

Clinical Features and Mortality of Nosocomial Candidemia in Very Old Patients: A Multicentre Italian Study

Year:

2020

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Format:

Elettronico

Referee:

Sì

Name of journal:

Gerontology

ISSN of journal:

0304-324X

N° Volume:

66

Number or Folder:

6

Page numbers:

532-541

Keyword:

Candidemia; Elderly people; Epidemiology; Risk factors; Infectious diseases; Mortality

Short description of contents:

Introduction: Being elderly is a well-known risk factor for candidemia, but few data are available on the prognostic impact of candidemia in the very old (VO) subjects, as defined as people aged >= 75 years. Objective: The aim of this study was to assess risk factors for nosocomial candidemia in two groups of candidemia patients, consisting of VO patients (>= 75 years) and adult and old (AO) patients (18-74 years). In addition, risk factors for death (30-day mortality) were analysed separately in the two groups. Methods: We included all consecutive candidemia episodes from January 2011 to December 2013 occurring in six referral hospitals in north-eastern Italy. Results: A total of 683 nosocomial candidemia episodes occurred. Of those, 293 (42.9%) episodes were in VO and 390 (57.1%) in AO patients. Hospitalization in medical wards, chronic renal failure, urinary catheter, and peripheral parenteral nutrition (PPN) were more common in VO than in AO patients. In the former patient group, adequate antifungal therapy (73.2%) and central venous catheter (CVC) removal (67.6%) occurred less frequently than in AO patients (82.5 and 80%, p < 0.002 and p < 0.004, respectively). Thirty-day mortality was higher in VO compared to AO patients (47.8 vs. 23.6%, p < 0.0001). In AO patients, independent risk factors for death were age (OR 1.04, 95% CI 1.00-1.09, p = 0.038), recent history of chemotherapy (OR 22.01, 95% CI 3.12-155.20, p = 0.002), and severity of sepsis (OR 40.68, 95% CI 7.42-223.10, p < 0.001); CVC removal was associated with higher probability of survival (OR 0.10, 95% CI 0.03-0.33, p < 0.001). In VO patients, independent risk factors for death were PPN (OR 3.5, 95% CI 1.17-10.47, p = 0.025) and hospitalization in medical wards (OR 2.58, 95% CI 1.02-6.53, p = 0.046), while CVC removal was associated with improved survival (OR 0.40, 95% CI 0.16-1.00, p = 0.050). Conclusion: Thirty-day mortality was high among VO patients and was associated with inadequate management of candidemia, especially in medical wards.

Product ID:

119542

Handle IRIS:

11562/1037204

Last Modified:

November 15, 2022

Bibliographic citation:

Zatta, M; Di Bella, S; Giacobbe, Dr; Del Puente, F; Merelli, M; Azzini, Am; Brugnaro, P; Vedovelli, C; Cattelan, Am; Busetti, M; Gatti, G; Bassetti, M; Luzzati, R, Clinical Features and Mortality of Nosocomial Candidemia in Very Old Patients: A Multicentre Italian Study «Gerontology» , vol. 66 , n. 6 , 2020 , pp. 532-541

Consulta la scheda completa presente nel repository istituzionale della Ricerca di Ateneo