{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:14:21Z","timestamp":1789668861661,"version":"4.0.1"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1K23AI175676-01A1"],"award-info":[{"award-number":["1K23AI175676-01A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR002378"],"award-info":[{"award-number":["UL1TR002378"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["KL2TR002381"],"award-info":[{"award-number":["KL2TR002381"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"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"}]},{"name":"Carlyle Fraser Heart Center"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Candidemia (Candida bloodstream infection [C-BSI]) in left ventricular assist device (LVAD) recipients is poorly understood. This study aimed to investigate the incidence, risk factors and outcomes of C-BSI in LVAD recipients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We screened 656 adults who underwent LVAD implantation at our institution from 1 January 2015 to 4 April 2024. Patients with C-BSI (n = 18) were compared with 2 control groups: (1) matched LVAD recipients with no bloodstream infection (N-BSI; matched 1:5; n = 90) to determine risk factors for C-BSI and (2) unmatched LVAD recipients with bacteremia (bacterial BSI [B-BSI]; n = 79) to compare mortality and infectious complication rates. A random forest model identified key predictive factors for C-BSI. Kaplan-Meier survival curves were used for time-to-event analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Median time to C-BSI was 20 days after implantation (interquartile range, 6\u201342 days). Compared to N-BSI, C-BSI were more likely to require perioperative temporary mechanical circulatory support (9 patients [50%] vs 8 [8.9%], respectively), renal replacement therapy (12 [67%] vs 6 [6.7%]), total parenteral nutrition (6 [33%] vs 2 [2.2%]), and prolonged postoperative mechanical ventilation (for 12 days vs 1 day) (all P &amp;lt; .001). A random forest model identified ventilation duration, renal replacement therapy, and total parenteral nutrition as top predictors of C-BSI. In terms of outcomes, C-BSI was more likely to lead to device endocarditis than B-BSI (in 5 [28%] vs 7 [9.1%], respectively; P = .008) and was associated with shorter median survival after infection (25 [interquartile range, 12 to not estimable due to censoring] vs 490 [54 to not estimable due to censoring] days; P = .04).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>C-BSI occurs early in LVAD recipients and is associated with a high mortality rate. Identified risk factors identified may guide antifungal prophylaxis or early empiric antifungal treatment in this susceptible patient population.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf251","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T17:25:51Z","timestamp":1745601951000},"source":"Crossref","is-referenced-by-count":4,"title":["Candidemia in Left Ventricular Assist Device Recipients: Incidence, Risk Factors, and Outcomes"],"prefix":"10.1093","volume":"12","author":[{"given":"Rebecca","family":"Anderson","sequence":"first","affiliation":[{"name":"Emory University School of Medicine , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5628-2444","authenticated-orcid":false,"given":"Stephanie","family":"Pouch","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Disease, Emory University School of Medicine , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5332-5883","authenticated-orcid":false,"given":"Lindsay","family":"Busch","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Disease, Emory University School of Medicine , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3251-6509","authenticated-orcid":false,"given":"Taylor","family":"Hayes","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Disease, Emory University School of Medicine , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susie","family":"Sennhauser","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Emory University School of Medicine , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7220-561X","authenticated-orcid":false,"given":"Joshua L","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2469-0638","authenticated-orcid":false,"given":"Emily M","family":"Eichenberger","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Disease, Emory University School of Medicine , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"key":"2025052602115317200_ofaf251-B1","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1016\/j.healun.2020.03.002","article-title":"Left ventricular assist systems and infection-related outcomes: a comprehensive analysis of the MOMENTUM 3 trial","volume":"39","author":"Patel","year":"2020","journal-title":"J Heart Lung Transplant"},{"key":"2025052602115317200_ofaf251-B2","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1016\/j.healun.2024.03.004","article-title":"The International Society for Heart and Lung Transplantation (ISHLT): 2024 infection definitions for durable and acute mechanical circulatory support devices","volume":"43","author":"Aslam","year":"2024","journal-title":"J Heart Lung Transplant"},{"key":"2025052602115317200_ofaf251-B3","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.idc.2024.07.005","article-title":"Infections in patients with mechanical circulatory support","volume":"38","author":"Eichenberger","year":"2024","journal-title":"Infect Dis Clin North Am"},{"key":"2025052602115317200_ofaf251-B4","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/j.healun.2018.04.006","article-title":"Bloodstream infections in mechanical circulatory support device recipients in the International Society of Heart and Lung Transplantation Mechanically Assisted Circulation Support Registry: epidemiology, risk factors, and mortality","volume":"37","author":"Aslam","year":"2018","journal-title":"J Heart Lung Transplant"},{"key":"2025052602115317200_ofaf251-B5","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1086\/650454","article-title":"Risk factors and outcomes of fungal ventricular-assist device infections","volume":"50","author":"Aslam","year":"2010","journal-title":"Clin Infect Dis"},{"key":"2025052602115317200_ofaf251-B6","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1162\/REST_a_00318","article-title":"Genetic matching for estimating causal effects: a general multivariate matching method for achieving balance in observational studies","volume":"95","author":"Diamond","year":"2013","journal-title":"Rev Econ Stat"},{"key":"2025052602115317200_ofaf251-B7","author":"National Healthcare Safety Network"},{"key":"2025052602115317200_ofaf251-B8"},{"key":"2025052602115317200_ofaf251-B9","author":"Sjoberg"},{"key":"2025052602115317200_ofaf251-B10","author":"Sjoberg"},{"key":"2025052602115317200_ofaf251-B11","author":"parsnip"},{"key":"2025052602115317200_ofaf251-B12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v077.i01","article-title":"ranger: a fast implementation of random forests for high dimensional data in C++ and R","volume":"77","author":"Wright","year":"2017","journal-title":"J Stat Softw"},{"key":"2025052602115317200_ofaf251-B13","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1097\/MAT.0000000000001610","article-title":"Characteristics and outcomes of candidemia in patients with durable left ventricular assist device support","volume":"68","author":"Broderick","year":"2022","journal-title":"ASAIO J"},{"key":"2025052602115317200_ofaf251-B14","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1111\/j.1540-8191.2009.00919.x","article-title":"Fungemia associated with left ventricular assist device support","volume":"24","author":"Bagdasarian","year":"2009","journal-title":"J Card Surg"},{"key":"2025052602115317200_ofaf251-B15","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1186\/s13613-020-00755-8","article-title":"Epidemiology, clinical characteristics, and outcome of candidemia in critically ill patients in Germany: a single-center retrospective 10-year analysis","volume":"10","author":"Schroeder","year":"2020","journal-title":"Ann Intensive Care"},{"key":"2025052602115317200_ofaf251-B16","doi-asserted-by":"crossref","first-page":"e0252165","DOI":"10.1371\/journal.pone.0252165","article-title":"Candidemia in intensive care units over nine years at a large Italian university hospital: comparison with other wards","volume":"16","author":"Mazzanti","year":"2021","journal-title":"PLoS One"},{"key":"2025052602115317200_ofaf251-B17","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1016\/j.jacc.2022.01.017","article-title":"Trends and outcomes of left ventricular assist device therapy: JACC focus seminar","volume":"79","author":"Varshney","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2025052602115317200_ofaf251-B18","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1080\/13693780802369332","article-title":"Candida bloodstream infections in hemodialysis recipients","volume":"47","author":"Pyrgos","year":"2009","journal-title":"Med Mycol"},{"key":"2025052602115317200_ofaf251-B19","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":"2025052602115317200_ofaf251-B20","doi-asserted-by":"crossref","first-page":"3000605221131122","DOI":"10.1177\/03000605221131122","article-title":"Characteristics, risk factors, and outcomes of bloodstream Candida infections in the intensive care unit: a retrospective cohort study","volume":"51","author":"Hohmann","year":"2023","journal-title":"J Int Med Res"},{"key":"2025052602115317200_ofaf251-B21","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.idc.2009.04.008","article-title":"Fungal infections in the ICU","volume":"23","author":"Zilberberg","year":"2009","journal-title":"Infect Dis Clin North Am"},{"key":"2025052602115317200_ofaf251-B22","doi-asserted-by":"crossref","first-page":"e15038","DOI":"10.1111\/ctr.15038","article-title":"Candidemia in thoracic solid organ transplant recipients: characteristics and outcomes relative to matched uninfected and bacteremic thoracic organ transplant recipients","volume":"37","author":"Eichenberger","year":"2023","journal-title":"Clin Transplant"},{"key":"2025052602115317200_ofaf251-B23","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.idc.2015.10.013","article-title":"Invasive candidiasis","volume":"30","author":"McCarty","year":"2016","journal-title":"Infect Dis Clin North Am"},{"key":"2025052602115317200_ofaf251-B24","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":"2025052602115317200_ofaf251-B25","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1007\/s12281-023-00456-2","article-title":"The impact of corticosteroids on the outcome of fungal disease: a systematic review and meta-analysis","volume":"17","author":"Li","year":"2023","journal-title":"Curr Fungal Infect Rep"},{"key":"2025052602115317200_ofaf251-B26","doi-asserted-by":"crossref","first-page":"ofae286","DOI":"10.1093\/ofid\/ofae286","article-title":"Fungal foe and mechanical hearts: a retrospective case series on Candida auris bloodstream infection with left ventricular assist devices","volume":"11","author":"Kerai","year":"2024","journal-title":"Open Forum Infect Dis"},{"key":"2025052602115317200_ofaf251-B27","doi-asserted-by":"crossref","first-page":"489","DOI":"10.7326\/M22-3469","article-title":"Worsening spread of Candida auris in the United States, 2019 to 2021","volume":"176","author":"Lyman","year":"2023","journal-title":"Ann Intern Med"},{"key":"2025052602115317200_ofaf251-B28","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.idc.2021.03.007","article-title":"Candidemia and invasive candidiasis","volume":"35","author":"McCarty","year":"2021","journal-title":"Infect Dis Clin North Am"},{"key":"2025052602115317200_ofaf251-B29","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1093\/cid\/ciw691","article-title":"Simultaneous emergence of multidrug-resistant Candida auris on 3 continents confirmed by whole-genome sequencing and epidemiological analyses","volume":"64","author":"Lockhart","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2025052602115317200_ofaf251-B30","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1016\/j.jcmg.2018.01.024","article-title":"FDG PET\/CT for early detection and localization of left ventricular assist device infection: impact on patient management and outcome","volume":"12","author":"Kim","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2025052602115317200_ofaf251-B31","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1007\/s00134-014-3400-y","article-title":"Prognostic factors and historical trends in the epidemiology of candidemia in critically ill patients: an analysis of five multicenter studies sequentially conducted over a 9-year period","volume":"40","author":"Colombo","year":"2014","journal-title":"Intensive Care Med"},{"key":"2025052602115317200_ofaf251-B32","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1097\/CCM.0b013e318206c1ca","article-title":"Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study","volume":"39","author":"Kett","year":"2011","journal-title":"Crit Care Med"},{"key":"2025052602115317200_ofaf251-B33","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1086\/421946","article-title":"Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study","volume":"39","author":"Wisplinghoff","year":"2004","journal-title":"Clin Infect Dis"},{"key":"2025052602115317200_ofaf251-B34","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":"2025052602115317200_ofaf251-B35","doi-asserted-by":"crossref","first-page":"e280","DOI":"10.1016\/S1473-3099(24)00749-7","article-title":"Global guideline for the diagnosis and management of candidiasis: an initiative of the ECMM in cooperation with ISHAM and ASM","volume":"25","author":"Cornely","year":"2025","journal-title":"Lancet Infect Dis"},{"key":"2025052602115317200_ofaf251-B36","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1093\/cid\/cis021","article-title":"Impact of treatment strategy on outcomes in patients with candidemia and other forms of invasive candidiasis: a patient-level quantitative review of randomized trials","volume":"54","author":"Andes","year":"2012","journal-title":"Clin Infect Dis"},{"key":"2025052602115317200_ofaf251-B37","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1111\/aor.13378","article-title":"Device exchange versus nonexchange modalities in left ventricular assist device-specific infections: a systematic review and meta-analysis","volume":"43","author":"Bauer","year":"2019","journal-title":"Artif Organs"},{"key":"2025052602115317200_ofaf251-B38","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.ijid.2019.10.016","article-title":"Antifungal agents for invasive candidiasis in non-neutropenic critically ill adults: what do the guidelines recommend?","volume":"89","author":"Wang","year":"2019","journal-title":"Int J Infect Dis"},{"key":"2025052602115317200_ofaf251-B39","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1097\/CCM.0b013e318236f297","article-title":"Systemic antifungal therapy in critically ill patients without invasive fungal infection*","volume":"40","author":"Azoulay","year":"2012","journal-title":"Crit Care Med"},{"key":"2025052602115317200_ofaf251-B40","doi-asserted-by":"crossref","first-page":"S175","DOI":"10.1093\/infdis\/jiaa394","article-title":"Core recommendations for antifungal stewardship: a statement of the mycoses study group education and research consortium","volume":"222","author":"Johnson","year":"2020","journal-title":"J Infect Dis"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofaf251\/63011808\/ofaf251.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/12\/5\/ofaf251\/63011808\/ofaf251.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/12\/5\/ofaf251\/63011808\/ofaf251.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T06:12:11Z","timestamp":1748239931000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofaf251\/8120124"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,25]]},"references-count":40,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,4,28]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofaf251","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2025,4,25]]},"article-number":"ofaf251"}}