{"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":1791609267935,"version":"4.3.4"},"reference-count":36,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,9,27]],"date-time":"2020-09-27T00:00:00Z","timestamp":1601164800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Candidemia is among the most frequent nosocomial bloodstream infections. Landmark case\u2010control studies on amphotericin B and fluconazole estimated attributable mortality rates of 38% and 49%, respectively. After introduction of echinocandins, these may have decreased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a case\u2010control design, 100 consecutive, hospitalised patients with candidemia were enrolled at the University Hospital of Cologne, Germany between 2014 and 2017. Controls were patients without candidemia matched for age, sex, year and duration of hospitalisation, main admission diagnosis and Patient Clinical Complexity Level (PCCL). Main data captured were risk factors for candidemia, attributable mortality rates and diagnostic and therapeutic adherence according to the EQUAL <jats:italic>Candida<\/jats:italic> score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall mortality rates for cases and controls were 43% and 17% (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), respectively; day 30 mortality rates were 38% and 11% (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.03), accounting for an attributable mortality of 26% and 27%. Guideline adherence was higher in surviving vs non\u2010surviving patients: while survivors reached a median of 17 (IQR: 16\u201019) points, non\u2010surviving cases reached a median 16 (IQR: 14\u201018) points out of 22 maximum achievable points (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.028). Risk factors for candidemia were more frequent in cases compared to control patients, especially chronic pulmonary disease (25% vs 16%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0n.s.), chronic liver disease (21% vs 6%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002), stay on intensive care unit (70% vs 64%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0n.s.), respiratory failure (56% vs 50%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0n.s.) and central venous catheter (97% vs 35%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Attributable mortality of nosocomial candidemia is still substantial but has decreased compared to previous studies with similar design.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13177","type":"journal-article","created":{"date-parts":[[2020,9,4]],"date-time":"2020-09-04T01:13:40Z","timestamp":1599182020000},"page":"1373-1381","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Attributable mortality of candidemia after introduction of echinocandins"],"prefix":"10.1111","volume":"63","author":[{"given":"Florian B.","family":"Cornely","sequence":"first","affiliation":[{"name":"Department I of Internal Medicine Faculty of Medicine and University Hospital Cologne Excellence Center for Medical Mycology (ECMM) University of Cologne Cologne Germany"},{"name":"Medical University of Varna Varna Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9599-3137","authenticated-orcid":false,"given":"Oliver A.","family":"Cornely","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine Faculty of Medicine and University Hospital Cologne Excellence Center for Medical Mycology (ECMM) University of Cologne Cologne Germany"},{"name":"Faculty of Medicine and University Hospital Cologne Chair Translational Research Cologne Excellence Cluster on Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD) University of Cologne Cologne Germany"},{"name":"Clinical Trial Centre Cologne (ZKS K\u00f6ln) University of Cologne Cologne Germany"},{"name":"German Center for Infection Research (DZIF) Partner Site Bonn\u2010Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6766-8297","authenticated-orcid":false,"given":"Jon","family":"Salmanton\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine Faculty of Medicine and University Hospital Cologne Excellence Center for Medical Mycology (ECMM) University of Cologne Cologne Germany"},{"name":"Faculty of Medicine and University Hospital Cologne Chair Translational Research Cologne Excellence Cluster on Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD) University of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix C.","family":"Koehler","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne Chair Translational Research Cologne Excellence Cluster on Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD) University of Cologne Cologne Germany"},{"name":"Department II of Internal Medicine Faculty of Medicine and University Hospital Cologne Center for Molecular Medicine Cologne University of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7386-7495","authenticated-orcid":false,"given":"Philipp","family":"Koehler","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine Faculty 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