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Infectious Disease Consultation May Lower Candida Mortality

FRIDAY, Sept. 27, 2019 -- Mortality is lower for patients with candida bloodstream infection receiving an infectious disease consultation, according to a study published online Sept. 24 in The Lancet Infectious Diseases.

Carlos Mejia-Chew, M.D., from the Washington University School of Medicine in St. Louis, and colleagues conducted a retrospective study of patients with candida bloodstream infection. Ninety-day all-cause mortality was compared between individuals with and without an infectious disease consultation.

A total of 1,691 patients with candida bloodstream infection were analyzed: 45.9 and 54.1 percent had and did not have an infectious disease consultation, respectively. The researchers found that compared to patients who did not receive an infectious disease consultation, those in the infectious disease consultation group had lower 90-day mortality (29 versus 51 percent). Infectious disease consultation correlated with a hazard ratio of 0.81 for mortality in a model with inverse weighting by the propensity score. The median duration of antifungal therapy was longer in the consultation group (18 versus 14 days), and central-line removal (76 versus 59 percent), echocardiography use (57 versus 33 percent), and ophthalmological examinations (53 versus 17 percent) were performed more often. In the infectious disease consultation group, fewer patients were untreated (2 versus 14 percent).

"The protective effect of obtaining an infectious disease consultation on mortality in patients with candida bloodstream infection suggests that this consultation should be an integral part of the clinical care of patients with candidaemia," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Astellas Global Development Pharma, which funded the study.

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Posted: September 2019

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