{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T05:14:27Z","timestamp":1791609267671,"version":"4.3.4"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T00:00:00Z","timestamp":1641340800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100007705","name":"Astellas Global Development Pharma","doi-asserted-by":"publisher","award":["MYCA-15L03"],"award-info":[{"award-number":["MYCA-15L03"]}],"id":[{"id":"10.13039\/100007705","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Washington University Institute of Clinical and Translational Sciences"},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["TR002345"],"award-info":[{"award-number":["TR002345"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R24 HS19455"],"award-info":[{"award-number":["R24 HS19455"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study quantifies the mortality attributable to Candida bloodstream infections (BSI) in the modern era of echinocandins.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of adult patients admitted to Barnes Jewish Hospital, a 1368-bed tertiary care academic hospital, in Saint Louis, Missouri, from 1 February 2012 to 30 April 2019. We identified 626 adult patients with Candida BSI that were frequency-matched with 6269 control patients that had similar Candida BSI risk-factors. The 90-day all-cause mortality attributable to Candida BSI was calculated using three methods\u2014propensity score matching, matching by inverse weighting of propensity score, and stratified analysis by quintile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 90-day crude mortality was 42.4% (269 patients) for Candida BSI cases and 17.1% (1083 patients) for frequency-matched controls. Following propensity score-matching, the attributable risk difference for 90-day mortality was 28.4% with hazard ratio (HR) of 2.12 (95% confidence interval [CI], 1.98\u20132.25, P\u2005&amp;lt;\u2005.001). In the stratified analysis, the risk for mortality at 90 days was highest in patients in the lowest risk quintile to develop Candida BSI (hazard ratio [HR] 3.13 (95% CI, 2.33\u20134.19). Patients in this lowest risk quintile accounted for 81(61%) of the 130 untreated patients with Candida BSI. Sixty-nine percent of untreated patients (57\/83) died versus 35% of (49\/127) of treated patients (P\u2005&amp;lt;\u2005.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with Candida BSI continue to experience high mortality. Mortality attributable to Candida BSI was more pronounced in patients at lowest risk to develop Candida BSI. A higher proportion of these low-risk patients went untreated, experienced higher mortality, and should be the target of aggressive interventions to ensure timely, effective treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciac004","type":"journal-article","created":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T15:10:07Z","timestamp":1641309007000},"page":"1031-1036","source":"Crossref","is-referenced-by-count":72,"title":["Attributable Mortality of\n                    <i>Candida<\/i>\n                    Bloodstream Infections in the Modern Era: A Propensity Score Analysis"],"prefix":"10.1093","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4123-0518","authenticated-orcid":false,"given":"Patrick B","family":"Mazi","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University in St Louis School of Medicine , St Louis, Missouri , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret A","family":"Olsen","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University in St Louis School of Medicine , St Louis, Missouri , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dustin","family":"Stwalley","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University in St Louis School of Medicine , St Louis, Missouri , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana M","family":"Rauseo","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University in St Louis School of Medicine , St Louis, Missouri , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chapelle","family":"Ayres","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University in St Louis School of Medicine , St Louis, Missouri , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William G","family":"Powderly","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University in St Louis School of Medicine , St Louis, Missouri , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7612-4710","authenticated-orcid":false,"given":"Andrej","family":"Spec","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University in St Louis School of Medicine , St Louis, Missouri , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,1,5]]},"reference":[{"key":"2023060106451403700_CIT0001","doi-asserted-by":"crossref","first-page":"1732","DOI":"10.1056\/NEJMoa1801550","article-title":"Changes in prevalence of health care-associated infections in U.S. hospitals.","volume":"379","author":"Magill","year":"2018","journal-title":"N Engl J Med"},{"key":"2023060106451403700_CIT0002","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1056\/NEJMra1315399","article-title":"Invasive candidiasis.","volume":"373","author":"Kullberg","year":"2015","journal-title":"N Engl J Med"},{"key":"2023060106451403700_CIT0003","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/civ933","article-title":"Clinical practice guideline for the management of candidiasis: 2016 Update by the Infectious Diseases Society of America.","volume":"62","author":"Pappas","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2023060106451403700_CIT0004","doi-asserted-by":"crossref","first-page":"18026","DOI":"10.1038\/nrdp.2018.26","article-title":"Invasive candidiasis.","volume":"4","author":"Pappas","year":"2018","journal-title":"Nat Rev Dis Primers"},{"key":"2023060106451403700_CIT0005","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1111\/myc.13177","article-title":"Attributable mortality of candidemia after introduction of echinocandins.","volume":"63","author":"Cornely","year":"2020","journal-title":"Mycoses"},{"key":"2023060106451403700_CIT0006","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1086\/378745","article-title":"Attributable mortality of nosocomial candidemia, revisited.","volume":"37","author":"Gudlaugsson","year":"2003","journal-title":"Clin Infect Dis"},{"key":"2023060106451403700_CIT0007","doi-asserted-by":"crossref","first-page":"2642","DOI":"10.1001\/archinte.1988.00380120094019","article-title":"Hospital-acquired candidemia. 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