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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en"><named-content content-type="genus-species">Candida</named-content>
Infective Endocarditis: an Observational Cohort Study with a Focus on Therapy</title>
<author><name sortKey="Arnold, Christopher J" sort="Arnold, Christopher J" uniqKey="Arnold C" first="Christopher J." last="Arnold">Christopher J. Arnold</name>
<affiliation><nlm:aff id="aff1">Duke University Medical Center, Durham, North Carolina, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Johnson, Melissa" sort="Johnson, Melissa" uniqKey="Johnson M" first="Melissa" last="Johnson">Melissa Johnson</name>
<affiliation><nlm:aff id="aff1">Duke University Medical Center, Durham, North Carolina, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bayer, Arnold S" sort="Bayer, Arnold S" uniqKey="Bayer A" first="Arnold S." last="Bayer">Arnold S. Bayer</name>
<affiliation><nlm:aff id="aff2">Harbor-UCLA Medical Center, Los Angeles, California, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bradley, Suzanne" sort="Bradley, Suzanne" uniqKey="Bradley S" first="Suzanne" last="Bradley">Suzanne Bradley</name>
<affiliation><nlm:aff id="aff3">VA Ann Arbor Healthcare System and University of Michigan, Ann Arbor, Michigan, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Giannitsioti, Efthymia" sort="Giannitsioti, Efthymia" uniqKey="Giannitsioti E" first="Efthymia" last="Giannitsioti">Efthymia Giannitsioti</name>
<affiliation><nlm:aff id="aff4">Attikon University General Hospital, Athens, Greece</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mir, Jose M" sort="Mir, Jose M" uniqKey="Mir J" first="José M." last="Mir">José M. Mir</name>
<affiliation><nlm:aff id="aff5">Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tornos, Pilar" sort="Tornos, Pilar" uniqKey="Tornos P" first="Pilar" last="Tornos">Pilar Tornos</name>
<affiliation><nlm:aff id="aff6">Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tattevin, Pierre" sort="Tattevin, Pierre" uniqKey="Tattevin P" first="Pierre" last="Tattevin">Pierre Tattevin</name>
<affiliation><nlm:aff id="aff7">Pontchaillou University, Rennes, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Strahilevitz, Jacob" sort="Strahilevitz, Jacob" uniqKey="Strahilevitz J" first="Jacob" last="Strahilevitz">Jacob Strahilevitz</name>
<affiliation><nlm:aff id="aff8">Hadassah-Hebrew University, Jerusalem, Israel</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Spelman, Denis" sort="Spelman, Denis" uniqKey="Spelman D" first="Denis" last="Spelman">Denis Spelman</name>
<affiliation><nlm:aff id="aff9">Alfred Hospital and Monash University, Melbourne, Australia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Athan, Eugene" sort="Athan, Eugene" uniqKey="Athan E" first="Eugene" last="Athan">Eugene Athan</name>
<affiliation><nlm:aff id="aff10">Barwon Health, Geelong, Australia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nacinovich, Francisco" sort="Nacinovich, Francisco" uniqKey="Nacinovich F" first="Francisco" last="Nacinovich">Francisco Nacinovich</name>
<affiliation><nlm:aff id="aff11">Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fortes, Claudio Q" sort="Fortes, Claudio Q" uniqKey="Fortes C" first="Claudio Q." last="Fortes">Claudio Q. Fortes</name>
<affiliation><nlm:aff id="aff12">Hospital Universitario Clementino Fraga Filho/UFRJ, Rio de Janeiro, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lamas, Cristiane" sort="Lamas, Cristiane" uniqKey="Lamas C" first="Cristiane" last="Lamas">Cristiane Lamas</name>
<affiliation><nlm:aff id="aff13">Instituto Nacional de Cardiologia and Unigranrio, Rio de Janeiro, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Barsic, Bruno" sort="Barsic, Bruno" uniqKey="Barsic B" first="Bruno" last="Barsic">Bruno Barsic</name>
<affiliation><nlm:aff id="aff14">University Hospital for Infectious Diseases, Zagreb, Croatia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fernandez Hidalgo, Nuria" sort="Fernandez Hidalgo, Nuria" uniqKey="Fernandez Hidalgo N" first="Nuria" last="Fernández-Hidalgo">Nuria Fernández-Hidalgo</name>
<affiliation><nlm:aff id="aff6">Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mu Oz, Patricia" sort="Mu Oz, Patricia" uniqKey="Mu Oz P" first="Patricia" last="Mu Oz">Patricia Mu Oz</name>
<affiliation><nlm:aff id="aff15">Hospital General Universitario Gregorio Marañón, Madrid, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Chu, Vivian H" sort="Chu, Vivian H" uniqKey="Chu V" first="Vivian H." last="Chu">Vivian H. Chu</name>
<affiliation><nlm:aff id="aff1">Duke University Medical Center, Durham, North Carolina, USA</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">25645855</idno>
<idno type="pmc">4356766</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356766</idno>
<idno type="RBID">PMC:4356766</idno>
<idno type="doi">10.1128/AAC.04867-14</idno>
<date when="2015">2015</date>
<idno type="wicri:Area/Pmc/Corpus">001743</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001743</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main"><named-content content-type="genus-species">Candida</named-content>
Infective Endocarditis: an Observational Cohort Study with a Focus on Therapy</title>
<author><name sortKey="Arnold, Christopher J" sort="Arnold, Christopher J" uniqKey="Arnold C" first="Christopher J." last="Arnold">Christopher J. Arnold</name>
<affiliation><nlm:aff id="aff1">Duke University Medical Center, Durham, North Carolina, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Johnson, Melissa" sort="Johnson, Melissa" uniqKey="Johnson M" first="Melissa" last="Johnson">Melissa Johnson</name>
<affiliation><nlm:aff id="aff1">Duke University Medical Center, Durham, North Carolina, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bayer, Arnold S" sort="Bayer, Arnold S" uniqKey="Bayer A" first="Arnold S." last="Bayer">Arnold S. Bayer</name>
<affiliation><nlm:aff id="aff2">Harbor-UCLA Medical Center, Los Angeles, California, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bradley, Suzanne" sort="Bradley, Suzanne" uniqKey="Bradley S" first="Suzanne" last="Bradley">Suzanne Bradley</name>
<affiliation><nlm:aff id="aff3">VA Ann Arbor Healthcare System and University of Michigan, Ann Arbor, Michigan, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Giannitsioti, Efthymia" sort="Giannitsioti, Efthymia" uniqKey="Giannitsioti E" first="Efthymia" last="Giannitsioti">Efthymia Giannitsioti</name>
<affiliation><nlm:aff id="aff4">Attikon University General Hospital, Athens, Greece</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mir, Jose M" sort="Mir, Jose M" uniqKey="Mir J" first="José M." last="Mir">José M. Mir</name>
<affiliation><nlm:aff id="aff5">Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tornos, Pilar" sort="Tornos, Pilar" uniqKey="Tornos P" first="Pilar" last="Tornos">Pilar Tornos</name>
<affiliation><nlm:aff id="aff6">Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tattevin, Pierre" sort="Tattevin, Pierre" uniqKey="Tattevin P" first="Pierre" last="Tattevin">Pierre Tattevin</name>
<affiliation><nlm:aff id="aff7">Pontchaillou University, Rennes, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Strahilevitz, Jacob" sort="Strahilevitz, Jacob" uniqKey="Strahilevitz J" first="Jacob" last="Strahilevitz">Jacob Strahilevitz</name>
<affiliation><nlm:aff id="aff8">Hadassah-Hebrew University, Jerusalem, Israel</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Spelman, Denis" sort="Spelman, Denis" uniqKey="Spelman D" first="Denis" last="Spelman">Denis Spelman</name>
<affiliation><nlm:aff id="aff9">Alfred Hospital and Monash University, Melbourne, Australia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Athan, Eugene" sort="Athan, Eugene" uniqKey="Athan E" first="Eugene" last="Athan">Eugene Athan</name>
<affiliation><nlm:aff id="aff10">Barwon Health, Geelong, Australia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nacinovich, Francisco" sort="Nacinovich, Francisco" uniqKey="Nacinovich F" first="Francisco" last="Nacinovich">Francisco Nacinovich</name>
<affiliation><nlm:aff id="aff11">Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fortes, Claudio Q" sort="Fortes, Claudio Q" uniqKey="Fortes C" first="Claudio Q." last="Fortes">Claudio Q. Fortes</name>
<affiliation><nlm:aff id="aff12">Hospital Universitario Clementino Fraga Filho/UFRJ, Rio de Janeiro, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lamas, Cristiane" sort="Lamas, Cristiane" uniqKey="Lamas C" first="Cristiane" last="Lamas">Cristiane Lamas</name>
<affiliation><nlm:aff id="aff13">Instituto Nacional de Cardiologia and Unigranrio, Rio de Janeiro, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Barsic, Bruno" sort="Barsic, Bruno" uniqKey="Barsic B" first="Bruno" last="Barsic">Bruno Barsic</name>
<affiliation><nlm:aff id="aff14">University Hospital for Infectious Diseases, Zagreb, Croatia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fernandez Hidalgo, Nuria" sort="Fernandez Hidalgo, Nuria" uniqKey="Fernandez Hidalgo N" first="Nuria" last="Fernández-Hidalgo">Nuria Fernández-Hidalgo</name>
<affiliation><nlm:aff id="aff6">Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mu Oz, Patricia" sort="Mu Oz, Patricia" uniqKey="Mu Oz P" first="Patricia" last="Mu Oz">Patricia Mu Oz</name>
<affiliation><nlm:aff id="aff15">Hospital General Universitario Gregorio Marañón, Madrid, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Chu, Vivian H" sort="Chu, Vivian H" uniqKey="Chu V" first="Vivian H." last="Chu">Vivian H. Chu</name>
<affiliation><nlm:aff id="aff1">Duke University Medical Center, Durham, North Carolina, USA</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Antimicrobial Agents and Chemotherapy</title>
<idno type="ISSN">0066-4804</idno>
<idno type="eISSN">1098-6596</idno>
<imprint><date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p><named-content content-type="genus-species">Candida</named-content>
infective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens for <named-content content-type="genus-species">Candida</named-content>
infective endocarditis. This prospective cohort study was based on 70 cases of <named-content content-type="genus-species">Candida</named-content>
infective endocarditis from the International Collaboration on Endocarditis (ICE)-Prospective Cohort Study and ICE-Plus databases collected between 2000 and 2010. The majority of infections were acquired nosocomially (67%). Congestive heart failure (24%), prosthetic heart valve (46%), and previous infective endocarditis (26%) were common comorbidities. Overall mortality was high, with 36% mortality in the hospital and 59% at 1 year. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality. Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy. Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion, <named-content content-type="genus-species">Candida</named-content>
infective endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Antimicrob Agents Chemother</journal-id>
<journal-id journal-id-type="iso-abbrev">Antimicrob. Agents Chemother</journal-id>
<journal-id journal-id-type="hwp">aac</journal-id>
<journal-id journal-id-type="pmc">aac</journal-id>
<journal-id journal-id-type="publisher-id">AAC</journal-id>
<journal-title-group><journal-title>Antimicrobial Agents and Chemotherapy</journal-title>
</journal-title-group>
<issn pub-type="ppub">0066-4804</issn>
<issn pub-type="epub">1098-6596</issn>
<publisher><publisher-name>American Society for Microbiology</publisher-name>
<publisher-loc>1752 N St., N.W., Washington, DC</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25645855</article-id>
<article-id pub-id-type="pmc">4356766</article-id>
<article-id pub-id-type="publisher-id">04867-14</article-id>
<article-id pub-id-type="doi">10.1128/AAC.04867-14</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Clinical Therapeutics</subject>
</subj-group>
</article-categories>
<title-group><article-title><named-content content-type="genus-species">Candida</named-content>
Infective Endocarditis: an Observational Cohort Study with a Focus on Therapy</article-title>
<alt-title alt-title-type="running-head"><named-content content-type="genus-species">Candida</named-content>
Infective Endocarditis</alt-title>
<alt-title alt-title-type="short-authors">Arnold et al.</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Arnold</surname>
<given-names>Christopher J.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>a</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Johnson</surname>
<given-names>Melissa</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>a</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bayer</surname>
<given-names>Arnold S.</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>b</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bradley</surname>
<given-names>Suzanne</given-names>
</name>
<xref ref-type="aff" rid="aff3"><sup>c</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Giannitsioti</surname>
<given-names>Efthymia</given-names>
</name>
<xref ref-type="aff" rid="aff4"><sup>d</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Miró</surname>
<given-names>José M.</given-names>
</name>
<xref ref-type="aff" rid="aff5"><sup>e</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tornos</surname>
<given-names>Pilar</given-names>
</name>
<xref ref-type="aff" rid="aff6"><sup>f</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tattevin</surname>
<given-names>Pierre</given-names>
</name>
<xref ref-type="aff" rid="aff7"><sup>g</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Strahilevitz</surname>
<given-names>Jacob</given-names>
</name>
<xref ref-type="aff" rid="aff8"><sup>h</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Spelman</surname>
<given-names>Denis</given-names>
</name>
<xref ref-type="aff" rid="aff9"><sup>i</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Athan</surname>
<given-names>Eugene</given-names>
</name>
<xref ref-type="aff" rid="aff10"><sup>j</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nacinovich</surname>
<given-names>Francisco</given-names>
</name>
<xref ref-type="aff" rid="aff11"><sup>k</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fortes</surname>
<given-names>Claudio Q.</given-names>
</name>
<xref ref-type="aff" rid="aff12"><sup>l</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lamas</surname>
<given-names>Cristiane</given-names>
</name>
<xref ref-type="aff" rid="aff13"><sup>m</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Barsic</surname>
<given-names>Bruno</given-names>
</name>
<xref ref-type="aff" rid="aff14"><sup>n</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fernández-Hidalgo</surname>
<given-names>Nuria</given-names>
</name>
<xref ref-type="aff" rid="aff6"><sup>f</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Muñoz</surname>
<given-names>Patricia</given-names>
</name>
<xref ref-type="aff" rid="aff15"><sup>o</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chu</surname>
<given-names>Vivian H.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>a</sup>
</xref>
</contrib>
<on-behalf-of>for the ICE Investigators</on-behalf-of>
<aff id="aff1"><label>a</label>
Duke University Medical Center, Durham, North Carolina, USA</aff>
<aff id="aff2"><label>b</label>
Harbor-UCLA Medical Center, Los Angeles, California, USA</aff>
<aff id="aff3"><label>c</label>
VA Ann Arbor Healthcare System and University of Michigan, Ann Arbor, Michigan, USA</aff>
<aff id="aff4"><label>d</label>
Attikon University General Hospital, Athens, Greece</aff>
<aff id="aff5"><label>e</label>
Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain</aff>
<aff id="aff6"><label>f</label>
Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain</aff>
<aff id="aff7"><label>g</label>
Pontchaillou University, Rennes, France</aff>
<aff id="aff8"><label>h</label>
Hadassah-Hebrew University, Jerusalem, Israel</aff>
<aff id="aff9"><label>i</label>
Alfred Hospital and Monash University, Melbourne, Australia</aff>
<aff id="aff10"><label>j</label>
Barwon Health, Geelong, Australia</aff>
<aff id="aff11"><label>k</label>
Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina</aff>
<aff id="aff12"><label>l</label>
Hospital Universitario Clementino Fraga Filho/UFRJ, Rio de Janeiro, Brazil</aff>
<aff id="aff13"><label>m</label>
Instituto Nacional de Cardiologia and Unigranrio, Rio de Janeiro, Brazil</aff>
<aff id="aff14"><label>n</label>
University Hospital for Infectious Diseases, Zagreb, Croatia</aff>
<aff id="aff15"><label>o</label>
Hospital General Universitario Gregorio Marañón, Madrid, Spain</aff>
</contrib-group>
<author-notes><corresp id="cor1">Address correspondence to Christopher J. Arnold, <email>christopher.arnold@duke.edu</email>
.</corresp>
<fn fn-type="other"><p><bold>Citation</bold>
Arnold CJ, Johnson M, Bayer AS, Bradley S, Giannitsioti E, Miró JM, Tornos P, Tattevin P, Strahilevitz J, Spelman D, Athan E, Nacinovich F, Fortes CQ, Lamas C, Barsic B, Fernández-Hidalgo N, Muñoz P, Chu VH, ICE Investigators. 2015. <named-content content-type="genus-species">Candida</named-content>
infective endocarditis: an observational cohort study with a focus on therapy. Antimicrob Agents Chemother 59:2365–2373. doi:<ext-link ext-link-type="uri" xlink:href="http://dx.doi.org/10.1128/AAC.04867-14">10.1128/AAC.04867-14</ext-link>
.</p>
</fn>
</author-notes>
<pub-date pub-type="epreprint"><day>2</day>
<month>2</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>11</day>
<month>3</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub"><month>4</month>
<year>2015</year>
</pub-date>
<volume>59</volume>
<issue>4</issue>
<fpage>2365</fpage>
<lpage>2373</lpage>
<history><date date-type="received"><day>2</day>
<month>12</month>
<year>2014</year>
</date>
<date date-type="rev-request"><day>13</day>
<month>1</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>28</day>
<month>1</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2015, American Society for Microbiology. All Rights Reserved.</copyright-statement>
<copyright-year>2015</copyright-year>
<copyright-holder>American Society for Microbiology</copyright-holder>
</permissions>
<self-uri content-type="pdf" xlink:href="zac00415002365.pdf"></self-uri>
<abstract><p><named-content content-type="genus-species">Candida</named-content>
infective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens for <named-content content-type="genus-species">Candida</named-content>
infective endocarditis. This prospective cohort study was based on 70 cases of <named-content content-type="genus-species">Candida</named-content>
infective endocarditis from the International Collaboration on Endocarditis (ICE)-Prospective Cohort Study and ICE-Plus databases collected between 2000 and 2010. The majority of infections were acquired nosocomially (67%). Congestive heart failure (24%), prosthetic heart valve (46%), and previous infective endocarditis (26%) were common comorbidities. Overall mortality was high, with 36% mortality in the hospital and 59% at 1 year. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality. Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy. Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion, <named-content content-type="genus-species">Candida</named-content>
infective endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis.</p>
</abstract>
<counts><fig-count count="0"></fig-count>
<table-count count="5"></table-count>
<equation-count count="0"></equation-count>
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<page-count count="9"></page-count>
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</article-meta>
</front>
</pmc>
</record>
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