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

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2024年9月27日

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Florian Reizine,
Nicolas Massart,
Alexandre Mansour,
Yannick Fedun,
Anaïs Machut,
Charles-Hervé Vacheron,
Anne Savey,
Arnaud Friggeri,
Alain Lepape,
Serge Alfandari,
Alexandra Allaire,
Antonio Alvarez,
Ammenouche Nacim,
Laurent Argaus,
Gérard Audibert,
Caroline Aurel,
Odile Bajolet,
Frédéric Barbut,
Genevieve Barjon,
Patricia Baune,
Sébastien Beague,
Bassam Beilouny,
Nicolas Bele,
Nicolas Belin,
Cécile Bernerd,
Yasmina Berrouane,
Aziz Berrouba,
Julie Bertrand,
Claire Bianchi,
Sandrine Biangoma,
Fabienne Birot Jaulin,
Severine Bonjean,
Stéphanie Bordes-Couecou,
Abdenour Bouhara,
Philippe Bouillard,
Céline Bourigault,
Sylvie Bourzeix,
Sébastien Boutreux,
Hanene Bouzidi,
Julie Brochart,
Stéphanie Bulyez,
Marie Callanquin,
Nathalie Canu,
Matthieu Capron,
Daniel Carbognani,
Vincent Castelain,
Vincent Catanese,
Isabelle Cattaneo,
Vanessa Chartier,
Guillaume Chassaing,
Robert Chausset,
Mélanie Chauvet,
Fabrice Chopin,
Catherine Chubilleau,
Céline Clayer,
Agnès Cohen,
Sylvie Comparot,
Philippe Corne,
Marie-Elisabeth Cornesse,
Gaelle Corno,
Esther Cortes,
Patricia Courouble,
Christian Crombe,
Véronique Curnier,
Monzer Dabbachi,
Cédric Dananché,
Abla Daroukh,
Damien Dassant,
Martine Daumas,
Aurélien Daurat,
Dominique Deffarges,
Fanny Delanghe,
Olivier Delastre,
Joel Delhomme,
Jean Paul Délias,
Martine Delorme,
Fabienne Derramond,
Frédérique Diaw,
Isabelle Dijols,
Kamel Djedaini,
Loic Dopeux,
Sophie Duhoo,
Thierry Dulac,
Clarisse Dupin,
Laurène Dupont,
Michel Durand,
Isabelle Durand Joly,
Jean-Yves Dusseau,
Pierre Yves Egreteau,
Carole Eldin,
Florence Espinasse,
Eric Farfour,
Abdelhamid Fatah,
Yannick Fedun,
Luis Ferreira,
Pierre Fillatre,
Toufic Finge,
Véronique Fleurial,
Arnaud Florentin,
Agnès Fribourg,
Severine Gallais-Hoff,
Claude Galland,
Richard Galliot,
Sylvain Garnier,
Gaelle Gasan,
Julien Gaubert-Duclos,
Valérie Gauzere,
Thomas Geffriaud,
Isabelle Geneau,
Hughes Georges,
Solweig Gerbier Colomban,
Christophe Giacardi,
Sebastien Gibot,
Audrey Glanard,
Marion Gleize,
Marieline Goret,
Michele Gourgues,
Delphine Grau,
Béatrice Grisi,
Clotilde Groleau,
Liliane Grolier-Bois,
Catherine Guignabert,
Fethi Hadj-Slimane,
Emmanuelle Hammad,
Catherine Haond,
Marie Hélène Hausermann,
Francoise Hayo,
Christophe Henry,
Alexandre Herbland,
Julien Huntzinger,
Hervé Hyvernat,
Alexandre Jean,
Boris Jolibois,
Sylvie Joron,
Gauthier Julien,
Jean Kempf,
Lyes Knani,
Béatrice La Combe,
Marie Labruyere,
Sandrine Lacroix,
Bruno Lafon,
Katia Lamant,
Peggy Larroudé,
Anne Launoy,
Bernadette Laurent,
Thierry Lavigne,
Christine Lawrence,
Quoc Vien Le,
Muriel Le Coq,
Anne-Sophie Le Floch,
Fanny Le Fall,
Brigitte Le Tallec,
Lucie Lecoutre,
Stanislas Ledochowski,
Rusel Leon,
Claire Lepouse,
Thomas Lescot,
Mélanie Levrard,
Marie Laure Lier,
Anne Lignereux,
Benjamin Louart,
Claire Maheu,
Aurélie Maindron,
Francois Mallard,
Marie Reine Mallaret,
Bernard Mankikian,
Christiane Manzon,
Philippe Mardrus,
Jacques Mariot,
Audry Martin,
Emmanuelle Martin,
Maelle Martin,
Pascale Martres,
Virginie Maxime,
Olivier Meunier,
Ella-Pauline Meyer,
Ferhat Meziani,
Sébastien Moschietto,
Céline Muller,
Elodie Munier-Marion,
Caroline Neulier,
François Nicolas,
Jacques-Yves Nizou,
Christine Palitta,
Michel Pascal,
Olivier Passouant,
René-Gilles Patrigeon,
Frédérique Pavillard,
Sabine Peghaire,
Christophe Perdrix,
Jean-Sebastien Petit,
Judith Pibre,
Walter Picard,
Sylvie Picault,
Santiago Picos Gil,
Jérôme Pillot,
Patrick Pina,
Rémi Plattier,
Laurent Poiron,
Christian Pommier,
Gaël Pradel,
Cristian Prelipcean,
Paul-Simon Pugliesi,
Vincent Quenee,
Olga Raposo,
Eve Remy,
Sabine Reynaud Deforges,
Jean-Christophe Richard,
Sylvie Ricome,
Thomas Rimmele,
Adrien Robine,
Anne-Claude Roche,
Laetitia Rohr,
Gwenaël Rolland-Jacob,
Adrien Roques,
Catherine Rougier,
Jérôme Roustan,
Mélanie Saint-Leger,
Faouzi Saliba,
Dominique Sechaud,
Amine Si-Ali,
Catherine Simac,
Georges Simon,
Michel Sirodot,
Vincent Stoeckel,
Philippe Tagawa,
Marine Tasle,
Fabrice Thiollière,
Benoit Thiphagne,
Aurélie Thomas-Hervieu,
François Tinturier,
Alexandre Tonnelier,
Alexandre Toro,
David Tranvan,
Dominique Trivier,
Gilles Troché,
Rémi Trusson,
Lionel Ursulet,
Marie Laure Valdeyron,
Catherine Vallet,
Vanessa Van Rossem,
Laurence Vasse,
Myriam Venelle,
Christine Venot,
Antoine Vieillard-Baron,
Jean-François Vincent,
Michel Vitris,
Hussein Yassine,
Lassane Zanre,
Cecile Zylberfajn

摘要

Background

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.

Method

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.

Results

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).

Conclusion

In this large multicenter cohort of ICU patients, although remaining low, the rate of ICAC was higher among COVID-19 patients.