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Abstract：
UNASSIGNED: Candidemia is associated with morbidity and mortality in cancer patients. We analyzed adherence to the 2016 Infectious Diseases Society of America (IDSA) candidiasis guidelines and the reasons for guideline nonadherence. We also investigated whether matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) improved time to effective antifungal therapy compared with historical data (median, 43.2 hours).
UNASSIGNED: Cancer patients with candidemia between 1/1/17 and 12/31/19 were included. Adherence to 7 individual IDSA guideline components was assessed. Composite IDSA guideline adherence (defined as meeting ≥6 guideline components) was also assessed. Charts were reviewed to examine reasons for noncompliance.
UNASSIGNED: Of 157 patients with candidemia, 150 (95.5%) had infectious disease (ID) consultation. The median total time from blood culture collection to antifungal initiation was 42.1 hours. Excluding 39 patients with short treatment due to death, there was 100% adherence with surveillance blood cultures, followed by antifungal susceptibility testing (117/118, 99.2%), initial appropriate therapy (117/118, 99.2%), antifungal duration (110/118, 93.2%), line removal (82/91, 90.1%), eye exams (93/118, 78.8%), and step-down therapy (69/94, 73.4%). A quarter (30/118) did not meet composite IDSA guideline adherence. Univariate logistic regression suggested a relationship between poor cancer prognosis and incomplete adherence to the 2016 IDSA candidiasis guidelines (odds ratio, 8.6; 95% CI, 1.6-47).
UNASSIGNED: The addition of MALDI-TOF did not shorten time to effective antifungal therapy. Nearly all patients were seen by ID for candidemia. Poor cancer prognosis was a common factor for incomplete composite adherence to the 2016 IDSA candidiasis guidelines.
UNASSIGNED: Cancer patients with candidemia between 1/1/17 and 12/31/19 were included. Adherence to 7 individual IDSA guideline components was assessed. Composite IDSA guideline adherence (defined as meeting ≥6 guideline components) was also assessed. Charts were reviewed to examine reasons for noncompliance.
UNASSIGNED: Of 157 patients with candidemia, 150 (95.5%) had infectious disease (ID) consultation. The median total time from blood culture collection to antifungal initiation was 42.1 hours. Excluding 39 patients with short treatment due to death, there was 100% adherence with surveillance blood cultures, followed by antifungal susceptibility testing (117/118, 99.2%), initial appropriate therapy (117/118, 99.2%), antifungal duration (110/118, 93.2%), line removal (82/91, 90.1%), eye exams (93/118, 78.8%), and step-down therapy (69/94, 73.4%). A quarter (30/118) did not meet composite IDSA guideline adherence. Univariate logistic regression suggested a relationship between poor cancer prognosis and incomplete adherence to the 2016 IDSA candidiasis guidelines (odds ratio, 8.6; 95% CI, 1.6-47).
UNASSIGNED: The addition of MALDI-TOF did not shorten time to effective antifungal therapy. Nearly all patients were seen by ID for candidemia. Poor cancer prognosis was a common factor for incomplete composite adherence to the 2016 IDSA candidiasis guidelines.
摘要：
未经证实：念珠菌菌血症与癌症患者的发病率和死亡率相关。我们分析了2016年美国传染病学会（IDSA）念珠菌病指南的依从性以及指南不依从性的原因。我们还调查了与历史数据相比，基质辅助激光解吸/电离飞行时间（MALDI-TOF）是否改善了有效抗真菌治疗的时间（中位数，43.2小时)。
UNASSIGNED：包括1/1/17和12/31/19之间的念珠菌血症的癌症患者。评估了对7个单独的IDSA指南组件的依从性。还评估了综合IDSA指南的依从性（定义为满足≥6个指南组成部分）。对图表进行了审查，以检查不合规的原因。
未经证实：157例念珠菌血症患者中，150人（95.5％）进行了传染病（ID）咨询。从血液培养物收集到抗真菌开始的中位总时间为42.1小时。不包括39例因死亡而短期治疗的患者，100%坚持监测血液培养，其次是抗真菌药敏试验（117/118，99.2%），初始适当治疗（117/118，99.2%），抗真菌持续时间（110/118，93.2％），线去除(82/91，90.1%)，眼科检查(93/118，78.8%)，和降压治疗（69/94，73.4%）。四分之一(30/118)不符合综合IDSA指南遵守情况。单变量逻辑回归表明，不良癌症预后与对2016年IDSA念珠菌病指南的不完全依从性之间存在关系(比值比，8.6；95%CI，1.6-47）。
UNASSIGNED：添加MALDI-TOF并没有缩短有效抗真菌治疗的时间。几乎所有患者都通过ID看到念珠菌血症。癌症预后不良是2016年IDSA念珠菌病指南不完全综合依从性的常见因素。
UNASSIGNED：包括1/1/17和12/31/19之间的念珠菌血症的癌症患者。评估了对7个单独的IDSA指南组件的依从性。还评估了综合IDSA指南的依从性（定义为满足≥6个指南组成部分）。对图表进行了审查，以检查不合规的原因。
未经证实：157例念珠菌血症患者中，150人（95.5％）进行了传染病（ID）咨询。从血液培养物收集到抗真菌开始的中位总时间为42.1小时。不包括39例因死亡而短期治疗的患者，100%坚持监测血液培养，其次是抗真菌药敏试验（117/118，99.2%），初始适当治疗（117/118，99.2%），抗真菌持续时间（110/118，93.2％），线去除(82/91，90.1%)，眼科检查(93/118，78.8%)，和降压治疗（69/94，73.4%）。四分之一(30/118)不符合综合IDSA指南遵守情况。单变量逻辑回归表明，不良癌症预后与对2016年IDSA念珠菌病指南的不完全依从性之间存在关系(比值比，8.6；95%CI，1.6-47）。
UNASSIGNED：添加MALDI-TOF并没有缩短有效抗真菌治疗的时间。几乎所有患者都通过ID看到念珠菌血症。癌症预后不良是2016年IDSA念珠菌病指南不完全综合依从性的常见因素。
