{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T17:29:14Z","timestamp":1777570154779,"version":"3.51.4"},"reference-count":27,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T00:00:00Z","timestamp":1662681600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X22002094_as1\"><jats:title>Objective:<\/jats:title><jats:p>To evaluate the need for mandatory infectious diseases consultation (IDC) for candidemia in the setting of antimicrobial stewardship guidance.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22002094_as2\"><jats:title>Design:<\/jats:title><jats:p>Retrospective cohort study from January 2016 to December 2019.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22002094_as3\"><jats:title>Setting:<\/jats:title><jats:p>Academic quaternary-care referral center.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22002094_as4\"><jats:title>Patients:<\/jats:title><jats:p>All episodes of candidemia in adults (n = 92), excluding concurrent bacterial infection or death or hospice care within 48 hours.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22002094_as5\"><jats:title>Methods:<\/jats:title><jats:p>Primary outcome was all-cause 30-day mortality. Secondary outcomes included guideline-adherence and treatment choice. Guideline-adherence was assessed with the EQUAL <jats:italic>Candida<\/jats:italic> score.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22002094_as6\"><jats:title>Results:<\/jats:title><jats:p>Of 186 episodes of candidemia, 92 episodes in 88 patients were included. Central venous catheters (CVCs) were present in 66 episodes (71.7%) and were the most common infection source (N = 38, 41.3%). The most frequently isolated species was <jats:italic>Candida glabrata<\/jats:italic> (40 of 94, 42.6%). IDC was performed in 84 (91.3%) of 92 candidemia episodes. Mortality rates were 20.8% (16 of 77) in the IDC group versus 25% (2 of 8) in the no-IDC group (<jats:italic>P<\/jats:italic> = .67). Other comparisons were numerically different but not significant: repeat blood culture (98.8% vs 87.5%; <jats:italic>P<\/jats:italic> = .17), echocardiography (70.2% vs 50%; <jats:italic>P<\/jats:italic> = .26), CVC removal (91.7% vs 83.3%; <jats:italic>P<\/jats:italic> = .45), and initial echinocandin treatment (67.9% vs 50%; <jats:italic>P<\/jats:italic> = .44). IDC resulted in more ophthalmology examinations (67.9% vs 12.5%; <jats:italic>P<\/jats:italic> = .0035). All patients received antifungal therapy. Antimicrobial stewardship recommendations were performed in 19 episodes (20.7%). The median EQUAL <jats:italic>Candida<\/jats:italic> score with CVC was higher with IDC (16 vs 11; <jats:italic>P<\/jats:italic> = .001) but not in episodes without CVC (12 vs 11.5; <jats:italic>P<\/jats:italic> = .81).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22002094_as7\"><jats:title>Conclusions:<\/jats:title><jats:p>In the setting of an active antimicrobial stewardship program and high consultation rates, mandatory IDC may not be warranted for candidemia.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2022.209","type":"journal-article","created":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T17:25:38Z","timestamp":1662744338000},"page":"1102-1107","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":7,"title":["The interplay of infectious diseases consultation and antimicrobial stewardship in candidemia outcomes: A retrospective cohort study from 2016 to 2019"],"prefix":"10.1017","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4566-1905","authenticated-orcid":false,"given":"Jonathan H.","family":"Ryder","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9928-4546","authenticated-orcid":false,"given":"Trevor C.","family":"Van Schooneveld","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Lyden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Razan","family":"El Ramahi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8324-6414","authenticated-orcid":false,"given":"Erica J.","family":"Stohs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,9,9]]},"reference":[{"key":"S0899823X22002094_ref3","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa270"},{"key":"S0899823X22002094_ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1801550"},{"key":"S0899823X22002094_ref8","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ933"},{"key":"S0899823X22002094_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2013.11.012"},{"key":"S0899823X22002094_ref11","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13134"},{"key":"S0899823X22002094_ref16","doi-asserted-by":"publisher","DOI":"10.1002\/jgf2.159"},{"key":"S0899823X22002094_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2004.12.010"},{"key":"S0899823X22002094_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.mycmed.2019.08.002"},{"key":"S0899823X22002094_ref18","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy849"},{"key":"S0899823X22002094_ref13","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13275"},{"key":"S0899823X22002094_ref23","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa010"},{"key":"S0899823X22002094_ref25","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis021"},{"key":"S0899823X22002094_ref2","first-page":"e449","article-title":"Burden of candidemia in the United States, 2017","volume":"71","author":"Tsay","year":"2020","journal-title":"Clin Infect Dis"},{"key":"S0899823X22002094_ref5","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12746"},{"key":"S0899823X22002094_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.01.029"},{"key":"S0899823X22002094_ref27","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis889"},{"key":"S0899823X22002094_ref6","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13196"},{"key":"S0899823X22002094_ref17","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz412"},{"key":"S0899823X22002094_ref10","doi-asserted-by":"publisher","DOI":"10.3390\/jof7040275"},{"key":"S0899823X22002094_ref14","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1186"},{"key":"S0899823X22002094_ref19","volume-title":"The Nebraska Medical Center guidelines for management of invasive candidiasis","author":"Hermsen","year":"2011"},{"key":"S0899823X22002094_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"S0899823X22002094_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(19)30405-0"},{"key":"S0899823X22002094_ref22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0215996"},{"key":"S0899823X22002094_ref24","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac004"},{"key":"S0899823X22002094_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2021.07.015"},{"key":"S0899823X22002094_ref7","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12039"}],"container-title":["Infection Control &amp; 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