{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T04:30:54Z","timestamp":1791952254575,"version":"4.3.4"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"7","funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["CDC-RFA-CK17-1701)"],"award-info":[{"award-number":["CDC-RFA-CK17-1701)"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Injection drug use (IDU) is a known, but infrequent risk factor on candidemia; however, the opioid epidemic and increases in IDU may be changing the epidemiology of candidemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Active population-based surveillance for candidemia was conducted in selected US counties. Cases of candidemia were categorized as IDU cases if IDU was indicated in the medical records in the 12 months prior to the date of initial culture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During 2017, 1191 candidemia cases were identified in patients aged &amp;gt;12 years (incidence: 6.9 per 100 000 population); 128 (10.7%) had IDU history, and this proportion was especially high (34.6%) in patients with candidemia aged 19\u201344. Patients with candidemia and IDU history were younger than those without (median age, 35 vs 63 years; P &amp;lt; .001). Candidemia cases involving recent IDU were less likely to have typical risk factors including malignancy (7.0% vs 29.4%; relative risk [RR], 0.2 [95% confidence interval {CI}, .1\u2013.5]), abdominal surgery (3.9% vs 17.5%; RR, 0.2 [95% CI, .09\u2013.5]), and total parenteral nutrition (3.9% vs 22.5%; RR, 0.2 [95% CI, .07\u2013.4]). Candidemia cases with IDU occurred more commonly in smokers (68.8% vs 18.5%; RR, 3.7 [95% CI, 3.1\u20134.4]), those with hepatitis C (54.7% vs 6.4%; RR, 8.5 [95% CI, 6.5\u201311.3]), and in people who were homeless (13.3% vs 0.8%; RR, 15.7 [95% CI, 7.1\u201334.5]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinicians should consider injection drug use as a risk factor in patients with candidemia who lack typical candidemia risk factors, especially in those with who are 19\u201344 years of age and have community-associated candidemia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciz1061","type":"journal-article","created":{"date-parts":[[2019,10,29]],"date-time":"2019-10-29T16:10:12Z","timestamp":1572365412000},"page":"1732-1737","source":"Crossref","is-referenced-by-count":46,"title":["The Changing Epidemiology of Candidemia in the United States: Injection Drug Use as an Increasingly Common Risk Factor\u2014Active Surveillance in Selected Sites, United States, 2014\u20132017"],"prefix":"10.1093","volume":"71","author":[{"given":"Alexia Y","family":"Zhang","sequence":"first","affiliation":[{"name":"Oregon Public Health Division, Oregon Health Authority, Portland, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Shrum","sequence":"additional","affiliation":[{"name":"New Mexico Department of Health, Santa Fe, New Mexico, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Williams","sequence":"additional","affiliation":[{"name":"Mycotic Disease Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Petnic","sequence":"additional","affiliation":[{"name":"California Emerging Infections Program, Oakland, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joelle","family":"Nadle","sequence":"additional","affiliation":[{"name":"California Emerging Infections Program, Oakland, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Johnston","sequence":"additional","affiliation":[{"name":"Colorado Department of Public Health and Environment, Denver, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devra","family":"Barter","sequence":"additional","affiliation":[{"name":"Colorado Department of Public Health and Environment, Denver, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany","family":"Vonbank","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, St Paul, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Bonner","sequence":"additional","affiliation":[{"name":"Maryland Emerging Infections Program, Johns Hopkins School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemary","family":"Hollick","sequence":"additional","affiliation":[{"name":"Maryland Emerging Infections Program, Johns Hopkins School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaytlynn","family":"Marceaux","sequence":"additional","affiliation":[{"name":"Maryland Emerging Infections Program, Johns Hopkins School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Harrison","sequence":"additional","affiliation":[{"name":"Maryland Emerging Infections Program, Johns Hopkins School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Schaffner","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda L","family":"Tesini","sequence":"additional","affiliation":[{"name":"University of Rochester School of Medicine, Rochester, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica M","family":"Farley","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine and Atlanta Veterans Affairs Medical Center, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca A","family":"Pierce","sequence":"additional","affiliation":[{"name":"Oregon Public Health Division, Oregon Health Authority, Portland, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Phipps","sequence":"additional","affiliation":[{"name":"New Mexico Emerging Infections Program, University of New Mexico, Albuquerque, New Mexico, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajal K","family":"Mody","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, St Paul, Minnesota, USA"},{"name":"Division of State and Local Readiness, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom M","family":"Chiller","sequence":"additional","affiliation":[{"name":"Mycotic Disease Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan R","family":"Jackson","sequence":"additional","affiliation":[{"name":"Mycotic Disease Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Snigdha","family":"Vallabhaneni","sequence":"additional","affiliation":[{"name":"Mycotic Disease Branch, Centers for Disease Control and Prevention, Atlanta, 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