{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T17:04:28Z","timestamp":1784653468665,"version":"3.55.0"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:00Z","timestamp":1699488000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["140179\/2019\u20104"],"award-info":[{"award-number":["140179\/2019\u20104"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The natural history of candidemia in kidney transplant recipients (KTR) remains poorly understood. This study aimed to evaluate mortality, prognostic factors and overall graft loss after candidemia in KTRs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective multicentre study enrolling all KTRs \u226515\u2009years old with candidemia diagnosed at hospitals in Brazil, Spain and Italy from 2010 to 2020. Primary endpoints were mortality rates at 14 and 30\u2009days. Secondary endpoints were prognostic factors of 14\u2010day mortality and overall graft loss.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 93 KTRs of which 75 were from Brazil. The mean time interval from transplantation to the onset of candidemia was 45.2\u2009\u00b1\u200961.5\u2009months. 42% of all patients were on haemodialysis, 31.3% had an episode of sepsis and 39% underwent surgery within 30\u2009days before fungemia. European patients were more likely to receive echinocandin (32 vs. 72%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). 22.7% of Brazilian patients did not receive any antifungal before death. All\u2010cause mortality at 14\u2009days was higher in Brazil (41.3 vs. 11.1%, <jats:italic>p<\/jats:italic>\u2009=\u2009.016). <jats:italic>Candida<\/jats:italic> colonisation (OR 6.91 [95% CI: 1.08\u201344.3], <jats:italic>p<\/jats:italic>\u2009=\u2009.042) and hypotension (OR 4.87 [95% CI: 1.62\u201314.66], <jats:italic>p<\/jats:italic>\u2009=\u2009.005) were associated with 14\u2010day mortality. Echinocandin treatment had a protective effect (OR 0.19 [95% CI: 0.05\u20130.73], <jats:italic>p<\/jats:italic>\u2009=\u2009.015). Graft loss at 90\u2009days occurred in 48% of patients (70.7 in Brazil vs. 22.2% in Europe, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Candidemia in KTR is usually documented late after engraftment in patients requiring HD, surgical procedures and dysbiosis secondary to antibiotic use. Mortality was higher in Brazil. Echinocandin therapy was associated with improved survival.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13669","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T07:00:23Z","timestamp":1699599623000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Natural history and prognostic factors of candidemia in kidney transplant recipients: A retrospective, multinational study"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0360-9922","authenticated-orcid":false,"given":"Paula M.","family":"Pe\u00e7anha\u2010Pietrobom","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, Escola Paulista de Medicina Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1127-8282","authenticated-orcid":false,"given":"Vanessa S. S.","family":"Truda","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, Escola Paulista de Medicina Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Fern\u00e1ndez\u2010Ruiz","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201812 de Octubre\u2019 Instituto de Investigaci\u00f3n Sanitaria Hospital \u201812 de Octubre\u2019 (imas12)  Madrid Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas (CIBERINFEC) Instituto de Salud Carlos III (ISCIII)  Madrid Spain"},{"name":"Department of Medicine, Facultad de Medicina Universidad Complutense  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel Garc\u00eda","family":"Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases Hospital Universitario Reina Sof\u00eda\u2010IMIBIC\u2010Universidad de Cordoba  Cordoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa Cristina T.","family":"Sukiennik","sequence":"additional","affiliation":[{"name":"Santa Casa de Miseric\u00f3rdia de Porto Alegre  Porto Alegre Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Wagner De C. L.","family":"Santos","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Infection Control Universidade Federal do Maranh\u00e3o, Ebserh\u2010UFMA  S\u00e3o Luis Brazil"},{"name":"Instituto D'Or de Pesquisa e Ensino, IDOR Hospital UDI  S\u00e3o Luis Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6394-2861","authenticated-orcid":false,"given":"Maricela","family":"Valerio","sequence":"additional","affiliation":[{"name":"Department of Medicine, Facultad de Medicina Universidad Complutense  Madrid Spain"},{"name":"Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"CIBER Enfermedades Respiratorias\u2010CIBERES (CB06\/06\/0058)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Gioia","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease University Hospital Ramon y Cajal  Madrid Spain"},{"name":"IRYCIS\u2014Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria  Madrid Spain"},{"name":"CIBER\u2014Consorcio Centro de Investigaci\u00f3n Biom\u00e9dica en Red\u2010(CB21\/13\/00084) Instituto de Salud Carlos III, Ministerio de Ciencia e Innovaci\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Rodr\u00edguez\u2010Goncer","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201812 de Octubre\u2019 Instituto de Investigaci\u00f3n Sanitaria Hospital \u201812 de Octubre\u2019 (imas12)  Madrid Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas (CIBERINFEC) Instituto de Salud Carlos III (ISCIII)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2385-1759","authenticated-orcid":false,"given":"Daniele Roberto","family":"Giacobbe","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Health Sciences (DISSAL) University of Genoa  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0697-3992","authenticated-orcid":false,"given":"Antonio","family":"Vena","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Health Sciences (DISSAL) University of Genoa  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Machado","sequence":"additional","affiliation":[{"name":"Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Bassetti","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Health Sciences (DISSAL) University of Genoa  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Facultad de Medicina Universidad Complutense  Madrid Spain"},{"name":"Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"CIBER Enfermedades Respiratorias\u2010CIBERES (CB06\/06\/0058)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"Aguado","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201812 de Octubre\u2019 Instituto de Investigaci\u00f3n Sanitaria Hospital \u201812 de Octubre\u2019 (imas12)  Madrid Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas (CIBERINFEC) Instituto de Salud Carlos III (ISCIII)  Madrid Spain"},{"name":"Department of Medicine, Facultad de Medicina Universidad Complutense  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helio","family":"Tedesco\u2010Silva","sequence":"additional","affiliation":[{"name":"Hospital do Rim\u2010Funda\u00e7\u00e3o Oswaldo Ramos  S\u00e3o Paulo Brazil"},{"name":"Department of Medicine, Division of Nephrology, Escola Paulista de Medicina Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0793-8491","authenticated-orcid":false,"given":"Arnaldo Lopes","family":"Colombo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, Escola Paulista de Medicina Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof3040057"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6808a1"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2019.04.024"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2007.140087"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30304-3"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2018.26"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-014-3400-y"},{"key":"e_1_2_10_9_1","article-title":"Prognostic factors of Candida spp. bloodstream infection in adults: a nine\u2010year retrospective cohort study across tertiary hospitals in Brazil and Spain","volume":"6","author":"Agnelli C","year":"2021","journal-title":"Lancet Reg Health Am"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof3030041"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12380"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2009.00371.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13250"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13195"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13855"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12613"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1086\/651262"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ933"},{"key":"e_1_2_10_19_1","unstructured":"US Centers for Disease Control and Prevention National Healthcare Safety Network.Device\u2010Associated (DA) Module. Protocol and Instructions: Central Line\u2013Associated Bloodstream Infection (CLABSI) Event.2022."},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13507"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-013-3109-3"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31819daa14"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12644"},{"key":"e_1_2_10_24_1","unstructured":"European Committee on Antimicrobial Susceptibility Testing.Overview of Antifungal ECOFFs and Clinical Breakpoints for Yeasts Moulds and Dermatophytes Using the EUCAST E.Def 7.3 E.Def 9.3 and E.Def 11.0 Procedures Version 2.0; 2019. Accessed March 17 2023.https:\/\/www.eucast.org\/fileadmin\/src\/media\/PDFs\/EUCAST_files\/AFST\/Clinical_breakpoints\/EUCAST_BP_ECOFF_v2.0_20\u201009\u201024.pdf"},{"key":"e_1_2_10_25_1","unstructured":"Clinical and Laboratory Standards Institute (CLSI).Performance Standards for Antifungal Susceptibility Testing of Yeasts. CLSI Supplement M60. Wayne PA USA2020Accessed March 17 2023.https:\/\/clsi.org\/media\/1895\/m60ed1_sample.pdf"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac559"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0000642019"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1590\/2175-8239-jbn-2019-0234"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-020-00750-z"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0005722020"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0002502021"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00013-08"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/TXD.0000000000000673"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2009.02909.x"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.riam.2013.10.001"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01998-13"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof3020024"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12539"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0146909"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis021"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.17147"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy210.971"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis305"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.9.3640-3645.2005"}],"container-title":["Mycoses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.13669","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T08:55:12Z","timestamp":1707296112000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/myc.13669"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,9]]},"references-count":43,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1111\/myc.13669"],"URL":"https:\/\/doi.org\/10.1111\/myc.13669","archive":["Portico"],"relation":{},"ISSN":["0933-7407","1439-0507"],"issn-type":[{"value":"0933-7407","type":"print"},{"value":"1439-0507","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,9]]},"assertion":[{"value":"2023-05-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13669"}}