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Title: Factors associated with the development of septic shock in patients with candidemia: a post hoc analysis from two prospective cohorts
Author: Bassetti, Matteo
Vena, Antonio
Meroi, Marco
Cardozo Espinola, Celia
Cuervo Requena, Guillermo
Giacobbe, Daniele Roberto
Salavert, Miguel
Merino, Paloma
Gioia, Francesca
Fernández Ruiz, Mario
López Cortés, Luis Eduardo
Almirante, Benito
Escolà Vergé, Laura
Montejo, Miguel
Aguilar Guisado, Manuela
Puerta Alcalde, Pedro
Tasias, Mariona
Ruiz Gaitán, Alba
González, Fernando
Puig Asensio, Mireia
Marco Reverté, Francesc
Pemán, Javier
Fortún, Jesus
Aguado, José María
Soriano Viladomiu, Alex
Carratalà, Jordi
García Vidal, Carolina
Valerio, Maricela
Sartor, Assunta
Bouza, Emilio
Muñoz, Patricia
Keywords: Candidiasi
Xoc sèptic
Septic shock
Issue Date: 1-Jan-2020
Publisher: BioMed Central
Abstract: Background: 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. Methods: 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). Results: 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). Conclusions: 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.
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It is part of: Critical Care, 2020, vol. 24
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Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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