A Dedicated Mycosis Flask Increases the Likelihood of Identifying Candidemia Sepsis
Introduction: Candidemia is a severe condition associated with high mortality, and fungi are often not covered by empiric antimicrobial regimes for sepsis. Therefore, the shortest possible time to detection of yeast in the blood is of the essence. Materials and methods: We performed a cohort study o...
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| Format: | Article |
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MDPI AG
2023-04-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/9/4/441 |
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| author | Magnus G. Ahlström Valeria S. Antsupova Michael Pedersen Helle Krogh Johansen Dennis Schrøder Hansen Inge Jenny Dahl Knudsen |
| author_facet | Magnus G. Ahlström Valeria S. Antsupova Michael Pedersen Helle Krogh Johansen Dennis Schrøder Hansen Inge Jenny Dahl Knudsen |
| author_sort | Magnus G. Ahlström |
| collection | DOAJ |
| description | Introduction: Candidemia is a severe condition associated with high mortality, and fungi are often not covered by empiric antimicrobial regimes for sepsis. Therefore, the shortest possible time to detection of yeast in the blood is of the essence. Materials and methods: We performed a cohort study of blood culture flasks drawn from patients aged 18 or older in the capital region of Denmark. In 2018 a blood cultures set consisted of two aerobic and two anaerobic flasks. This was changed in 2020 to two aerobic, one anaerobic, and one mycosis flask. We used time-to-event statistics to model time to positivity and compared 2018 with 2020; further, we stratified analyses on the blood culture system used (BacTAlert™ vs. BACTEC™) and high-risk vs. low-risk departments. Results: We included 175,416 blood culture sets and 107,077 unique patients. We found an absolute difference in the likelihood of identifying fungi in a blood culture set of 1.2 (95% CI: 0.72; 1.6) pr. 1.000 blood culture sets corresponding to the number needed to treat 853 (617; 1382). In high-risk departments, the absolute difference was profound, whereas it was negligible and statistically non-significant in low-risk departments 5.2 (95% CI: 3.4; 7.1) vs. 0.16 (−0.17; 0.48) pr. 1.000 blood culture sets. Conclusions: We found that including a mycosis flask in a blood culture set increases the likelihood of identifying candidemia. The effect was mainly seen in high-risk departments. |
| first_indexed | 2024-03-11T04:52:16Z |
| format | Article |
| id | doaj.art-ac295fa10f5c441ba00c7965e6ac934d |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-11T04:52:16Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-ac295fa10f5c441ba00c7965e6ac934d2023-11-17T19:58:11ZengMDPI AGJournal of Fungi2309-608X2023-04-019444110.3390/jof9040441A Dedicated Mycosis Flask Increases the Likelihood of Identifying Candidemia SepsisMagnus G. Ahlström0Valeria S. Antsupova1Michael Pedersen2Helle Krogh Johansen3Dennis Schrøder Hansen4Inge Jenny Dahl Knudsen5Department of Clinical Microbiology, Herlev & Gentofte Hospital, 2730 Herlev, DenmarkDepartment of Clinical Microbiology, Herlev & Gentofte Hospital, 2730 Herlev, DenmarkDepartment of Clinical Microbiology, Amager & Hvidovre Hospital, 2650 Hvidovre, DenmarkDepartment of Clinical Microbiology, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Clinical Microbiology, Herlev & Gentofte Hospital, 2730 Herlev, DenmarkDepartment of Clinical Microbiology, Rigshospitalet, 2100 Copenhagen, DenmarkIntroduction: Candidemia is a severe condition associated with high mortality, and fungi are often not covered by empiric antimicrobial regimes for sepsis. Therefore, the shortest possible time to detection of yeast in the blood is of the essence. Materials and methods: We performed a cohort study of blood culture flasks drawn from patients aged 18 or older in the capital region of Denmark. In 2018 a blood cultures set consisted of two aerobic and two anaerobic flasks. This was changed in 2020 to two aerobic, one anaerobic, and one mycosis flask. We used time-to-event statistics to model time to positivity and compared 2018 with 2020; further, we stratified analyses on the blood culture system used (BacTAlert™ vs. BACTEC™) and high-risk vs. low-risk departments. Results: We included 175,416 blood culture sets and 107,077 unique patients. We found an absolute difference in the likelihood of identifying fungi in a blood culture set of 1.2 (95% CI: 0.72; 1.6) pr. 1.000 blood culture sets corresponding to the number needed to treat 853 (617; 1382). In high-risk departments, the absolute difference was profound, whereas it was negligible and statistically non-significant in low-risk departments 5.2 (95% CI: 3.4; 7.1) vs. 0.16 (−0.17; 0.48) pr. 1.000 blood culture sets. Conclusions: We found that including a mycosis flask in a blood culture set increases the likelihood of identifying candidemia. The effect was mainly seen in high-risk departments.https://www.mdpi.com/2309-608X/9/4/441candidemiablood culturetime to detectionmycosis flasksepsis |
| spellingShingle | Magnus G. Ahlström Valeria S. Antsupova Michael Pedersen Helle Krogh Johansen Dennis Schrøder Hansen Inge Jenny Dahl Knudsen A Dedicated Mycosis Flask Increases the Likelihood of Identifying Candidemia Sepsis Journal of Fungi candidemia blood culture time to detection mycosis flask sepsis |
| title | A Dedicated Mycosis Flask Increases the Likelihood of Identifying Candidemia Sepsis |
| title_full | A Dedicated Mycosis Flask Increases the Likelihood of Identifying Candidemia Sepsis |
| title_fullStr | A Dedicated Mycosis Flask Increases the Likelihood of Identifying Candidemia Sepsis |
| title_full_unstemmed | A Dedicated Mycosis Flask Increases the Likelihood of Identifying Candidemia Sepsis |
| title_short | A Dedicated Mycosis Flask Increases the Likelihood of Identifying Candidemia Sepsis |
| title_sort | dedicated mycosis flask increases the likelihood of identifying candidemia sepsis |
| topic | candidemia blood culture time to detection mycosis flask sepsis |
| url | https://www.mdpi.com/2309-608X/9/4/441 |
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