Relationship between SARS-CoV-2 infection and ICU-acquired candidemia in critically ill medical patients: a multicenter prospective cohort study

IF 8.8 1区医学 Q1 CRITICAL CARE MEDICINE

Critical Care Pub Date : 2024-09-27 DOI:10.1186/s13054-024-05104-w

Florian Reizine, Nicolas Massart, Alexandre Mansour, Yannick Fedun, Anaïs Machut, Charles-Hervé Vacheron, Anne Savey, Arnaud Friggeri, Alain Lepape

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引用次数: 0

Abstract

While SARS-CoV2 infection has been shown to be a significant risk-factor for several secondary bacterial, viral and Aspergillus infections, its impact on intensive care unit (ICU)-acquired candidemia (ICAC) remains poorly explored. Using the REA-REZO network (French surveillance network of ICU-acquired infections), we included all adult patients hospitalized for a medical reason of admission in participating ICUs for at least 48 h from January 2020 to January 2023. To account for confounders, a non-parsimonious propensity score matching was performed. Rates of ICAC according to SARS-CoV2 status were compared in matched patients. Factors associated with ICAC in COVID-19 patients were also assessed using a Fine-Gray model. A total of 55,268 patients hospitalized at least 48 h for a medical reason in 101 ICUs were included along the study period. Of those, 13,472 were tested positive for a SARS-CoV2 infection while 284 patients developed an ICAC. ICAC rate was higher in COVID-19 patients in both the overall population and the matched patients’ cohort (0.8% (107/13,472) versus 0.4% (173/41,796); p < 0.001 and 0.8% (93/12,241) versus 0.5% (57/12,241); p = 0.004, respectively). ICAC incidence rate was also higher in those patients (incidence rate 0.51 per 1000 patients-days in COVID-19 patients versus 0.32 per 1000 patients-days; incidence rate ratio: 1.58 [95% CI:1.08–2.35]; p = 0.018). Finally, patients with ICAC had a higher ICU mortality rate (49.6% versus 20.2%; p < 0.001). In this large multicenter cohort of ICU patients, although remaining low, the rate of ICAC was higher among COVID-19 patients.

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重症内科病人 SARS-CoV-2 感染与重症监护室获得性念珠菌血症之间的关系：一项多中心前瞻性队列研究

SARS-CoV2感染已被证明是多种继发性细菌、病毒和曲霉菌感染的重要风险因素，但其对重症监护病房（ICU）获得性念珠菌血症（ICAC）的影响仍未得到充分探讨。我们利用 REA-REZO 网络（法国重症监护病房获得性感染监测网络），纳入了 2020 年 1 月至 2023 年 1 月期间因医疗原因在参与网络的重症监护病房住院至少 48 小时的所有成人患者。为了考虑混杂因素，我们进行了非拟合倾向评分匹配。根据 SARS-CoV2 状态比较了匹配患者的 ICAC 发生率。还使用 Fine-Gray 模型评估了与 COVID-19 患者 ICAC 相关的因素。在研究期间，共有 55268 名患者因医疗原因在 101 个重症监护病房住院至少 48 小时。其中，13,472 名患者的 SARS-CoV2 感染检测呈阳性，284 名患者出现了 ICAC。在总体人群和匹配患者队列中，COVID-19 患者的 ICAC 发生率较高（分别为 0.8%（107/13,472）对 0.4%（173/41,796）；p < 0.001 和 0.8%（93/12,241）对 0.5%（57/12,241）；p = 0.004）。这些患者的 ICAC 发病率也更高（COVID-19 患者的发病率为每 1000 个患者日 0.51 例，而 COVID-19 患者的发病率为每 1000 个患者日 0.32 例；发病率比：1.58 [95% CI:1.08-2.35]; p = 0.018）。最后，ICAC 患者的 ICU 死亡率更高（49.6% 对 20.2%；P < 0.001）。在这一大型多中心 ICU 患者队列中，COVID-19 患者的 ICAC 发生率虽然仍然较低，但却较高。

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来源期刊

Critical Care 医学-危重病医学

CiteScore

20.60

自引率

3.30%

发文量

348

审稿时长

1.5 months

期刊介绍： Critical Care is an esteemed international medical journal that undergoes a rigorous peer-review process to maintain its high quality standards. Its primary objective is to enhance the healthcare services offered to critically ill patients. To achieve this, the journal focuses on gathering, exchanging, disseminating, and endorsing evidence-based information that is highly relevant to intensivists. By doing so, Critical Care seeks to provide a thorough and inclusive examination of the intensive care field.