Abstract ECMM-Candida III was a pan-European, multicentre observational study of adult patients with blood culture-proven candidemia. Among a total of 632 patients with candidemia across 64 institutions in 20 European countries, a sub-analysis of 396 (63%) cases occurring outside the intensive care unit (ICU) was conducted. Compared with ICU-patients, non-ICU patients had a higher comorbidity burden (median Charlson Comorbidity Index CCI 6 vs. 5 in ICU patients, p=0.006). Hematologic and oncologic malignancies were more frequent among non-ICU cases (45.5%, vs 28.4%, p0.001), whereas both chronic kidney and cardiovascular disease were more prevalent in ICU patients (p0.001). Non-ICU patients had significantly lower mortality in Kaplan-Meier survival analysis (p0.001). Post-surgical non-ICU patients (n=45) had the highest survival rate (73.3%, p=0.003) and the longest hospital stay, even after excluding all cases with a fatal outcome before Day 30. In non-ICU patients, older age, hemato-oncologic malignancies, chronic liver disease, and COVID-19 were all independently associated with mortality risk, while treatment consultation by an Infectious Diseases or Clinical Microbiology consultant, and initial treatment with an echinocandin, respectively higher EQUAL Candida scores were associated with lower mortality risk in the multivariable Cox regression models. In conclusion, despite higher co-morbidity rates, non-ICU patients with candidemia had higher survival rates.
Wolfgruber et al. (Thu,) studied this question.