{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T13:00:01Z","timestamp":1770814801140,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T00:00:00Z","timestamp":1560988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2019,9]]},"abstract":"Summary<\/jats:title>Geographical variation is observed in invasive candida infection (ICI<\/jats:styled-content>) and differences between critical care units (CCU<\/jats:styled-content>s) may contribute. To examine rates, risk factors and individual and unit\u2010level variation of ICI<\/jats:styled-content> in UK CCU<\/jats:styled-content>s. Data from the Fungal Infection Risk Evaluation Study was used to examine individuals admitted to 96 CCU<\/jats:styled-content>s in the UK<\/jats:styled-content>; July 2009\u2010March 2011. Cases were non\u2010neutropenic individuals aged 18\u00a0years and over with ICI<\/jats:styled-content> identified after admission. Mixed\u2010effects Poisson regression models adjusted for the CCU<\/jats:styled-content>. There were 225 cases of ICI<\/jats:styled-content>, a rate of 6.84\/10\u00a0000 bed days and a threefold variation between the lowest and highest UK<\/jats:styled-content> regions. Independent risk factors included abdominal surgery (adjusted incidence rate ratio (AIRR<\/jats:styled-content>) 2.03 95% CI<\/jats:styled-content> 1.49, 2.76), parenteral nutrition (AIRR<\/jats:styled-content> 1.89 95% CI<\/jats:styled-content> 1.33, 2.70), fungal colonisation at two or more sites (AIRR<\/jats:styled-content> 2.30 95% CI<\/jats:styled-content> 1.34, 3.95) and indwelling devices. Approximately 4% of the variation in ICI<\/jats:styled-content> rates could be attributed to the CCU<\/jats:styled-content>. We identified independent risk factors for ICI<\/jats:styled-content> and showed, for the first time, that the critical care unit effect was small. Despite this, future studies should consider the hierarchical structure of the data to ensure robust estimates.<\/jats:p>","DOI":"10.1111\/myc.12956","type":"journal-article","created":{"date-parts":[[2019,6,7]],"date-time":"2019-06-07T13:50:59Z","timestamp":1559915459000},"page":"790-795","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Individual risk factors and critical care unit effects on Invasive Candida Infection occurring in critical care units in the UK<\/scp>: A multilevel model"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4186-2884","authenticated-orcid":false,"given":"Lynsey","family":"Patterson","sequence":"first","affiliation":[{"name":"Health Protection Public Health Agency Belfast UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronan","family":"McMullan","sequence":"additional","affiliation":[{"name":"Department of Microbiology Kelvin Laboratories Royal Victoria Hospital, Belfast Trust Belfast UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Intensive Care National Audit & Research Centre London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,6,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-004-1103-y"},{"key":"e_1_2_9_3_1","unstructured":"Health Protection Agency.Voluntary surveillance of candidemia in England Wales and Northern Ireland: 2011.http:\/\/webarchive.nationalarchives.gov.uk\/20140714084352\/http:\/\/hpa.org.uk\/hpr\/archives\/2012\/hpr3812.pdf. 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