{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T17:04:06Z","timestamp":1784653446997,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,9,26]],"date-time":"2020-09-26T00:00:00Z","timestamp":1601078400000},"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":[[2020,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Few studies have investigated the clinical outcomes of patients with candidemia caused by <jats:italic>Candida<\/jats:italic> species with different levels of biofilm formation. We aimed to investigate the impact of antifungal therapy on the outcome of candidemia caused by <jats:italic>Candida<\/jats:italic> species that were categorised as low biofilm formers (LBFs), moderate biofilm formers (MBFs), and high biofilm formers (HBFs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adults with candidemia caused by LBF and HBF\/MBF <jats:italic>Candida<\/jats:italic> species that were susceptible to fluconazole and caspofungin were included to investigate the impact of treatment with fluconazole vs an echinocandin on 30\u2010day crude mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 215 patients with candidemia received fluconazole and 116 patients received an echinocandin. In multivariate analysis, Pittsburgh bacteremia score\u00a0\u2265\u00a04 (adjusted odds ratio [AOR] =2.42; 95% confidence interval [CI], 1.32\u20104.41), malignancy (AOR\u00a0=\u00a03.45; 95% CI, 1.83\u20106.51), not removing the central venous catheter within 48\u00a0hours of a positive blood culture (AOR\u00a0=\u00a04.69; 95% CI, 2.61\u20108.45), and treatment with fluconazole for candidemia due to HBF\/MBF <jats:italic>Candida<\/jats:italic> spp. (AOR\u00a0=\u00a02.23; 95% CI, 1.22\u20104.06) were independent factors associated with 30\u2010day mortality. Of the 165 patients infected by HBF\/MBF <jats:italic>Candida<\/jats:italic> isolates, those who received azole therapy had a significantly higher sepsis\u2010related mortality rate than those who received echinocandin therapy (44.9% [49\/109] vs 26.8% [15\/56], <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There was a trend of an independent association between fluconazole treatment and poor outcomes in the patients infected by HBF\/MBF <jats:italic>Candida<\/jats:italic> strains.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13179","type":"journal-article","created":{"date-parts":[[2020,9,26]],"date-time":"2020-09-26T07:16:07Z","timestamp":1601104567000},"page":"1382-1391","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Impact of biofilm production by <i>Candida<\/i> species and antifungal therapy on mortality of patients with candidemia"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9302-5220","authenticated-orcid":false,"given":"Chen\u2010Hsiang","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Chun","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I\u2010Ling","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan"},{"name":"School of Pharmacy Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang\u2010Ju","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Chih","family":"Chien","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mycmed.2017.02.007"},{"issue":"9","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.4065\/83.9.1011","article-title":"Treatment of invasive Candidal infections: systematic review and meta\u2010analysis","volume":"83","author":"Gafter\u2010Gvili A","year":"2008","journal-title":"Mayo Clin Proc"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMct060052"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ933"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2009.12.011"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.micinf.2009.04.018"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0966-842X(02)00002-1"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12014"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.40.4.1244-1248.2002"},{"issue":"4","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1093\/mmy\/myt031","article-title":"Is biofilm production a predictor of catheter\u2010related candidemia?","volume":"52","author":"Guembe M","year":"2014","journal-title":"Med Mycol"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.000207"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00131-07"},{"issue":"3","key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"e33705","DOI":"10.1371\/journal.pone.0033705","article-title":"Risk factors and outcomes of candidemia caused by biofilm\u2010forming isolates in a tertiary care hospital","volume":"7","author":"Tumbarello M","year":"2012","journal-title":"PLoS One"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2180-14-182"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00697-10"},{"key":"e_1_2_9_17_1","volume-title":"Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts; Fourth Informational Supplement","author":"CLSI","year":"2012"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0065621"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12644"},{"key":"e_1_2_9_21_1","first-page":"78","volume-title":"The Sanford guide to antimicrobial therapy","author":"Gilbert DN","year":"2009"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-017-4683-6"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2015.09.018"},{"issue":"3","key":"e_1_2_9_24_1","doi-asserted-by":"crossref","first-page":"253","DOI":"10.3109\/13693786.2010.530032","article-title":"Biofilm production and evaluation of antifungal susceptibility amongst clinical Candida spp. isolates, including strains of the Candida parapsilosis complex","volume":"49","author":"Melo AS","year":"2011","journal-title":"Med Mycol"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2017.11.005"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.1.506-508.2003"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.01.022"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis305"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis021"},{"issue":"1","key":"e_1_2_9_30_1","doi-asserted-by":"crossref","first-page":"33","DOI":"10.3109\/13693786.2012.686673","article-title":"Candida albicans and non\u2010Candida albicans fungemia in an institutional hospital during a decade","volume":"51","author":"Parmeland L","year":"2013","journal-title":"Med Mycol"}],"container-title":["Mycoses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.13179","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/myc.13179","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.13179","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T04:41:22Z","timestamp":1693802482000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/myc.13179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,26]]},"references-count":29,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1111\/myc.13179"],"URL":"https:\/\/doi.org\/10.1111\/myc.13179","archive":["Portico"],"relation":{},"ISSN":["0933-7407","1439-0507"],"issn-type":[{"value":"0933-7407","type":"print"},{"value":"1439-0507","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,26]]},"assertion":[{"value":"2020-03-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}