Candida in the respiratory tract secretions of critically ill patients and the impact of antifungal treatment: a randomized placebo controlled ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-07-01

AUTHORS

Martin Albert, David Williamson, John Muscedere, Francois Lauzier, Coleman Rotstein, Salmaan Kanji, Xuran Jiang, Mark Hall, Daren Heyland

ABSTRACT

PurposeCandida spp. are frequently recovered from endotracheal secretions in critically ill patients suspected of having ventilator-associated pneumonia. Observational studies reported an association with worse clinical outcomes but the effect of antifungal therapy in these patients remains unclear. We designed this pilot study to assess the feasibility of a larger trial and to evaluate inflammatory profiles and clinical outcomes in these patients.MethodsWe conducted a double-blind, placebo-controlled, multicenter pilot randomized trial of antifungal therapy in critically ill patients with a clinical suspicion of ventilator-associated pneumonia with positive airway secretion specimens for Candida spp. We also included an observational group without Candida spp. in their airway secretions. We measured recruitment rate, inflammatory and innate immune function profiles over time, and clinical outcomes.ResultsWe recruited 60 patients into the randomized trial and 29 patients into the observational study. Markers of inflammation and all clinical outcomes were comparable between placebo and antifungal treatment group at baseline and over time. At baseline, plasma TNF-α levels were higher in patients with VAP and Candida compared to the observational group (mean ± SD) (21.8 ± 23.1 versus 12.4 ± 9.3 pg/ml, p = 0.02) and these patients had lower innate immune function as evidenced by reduced whole blood ex vivo LPS-induced TNF-α production capacity (854.8 ± 855.2 versus 1,559.4 ± 1,290.6 pg/ml, p = 0.01).ConclusionsThis study does not provide evidence to support a larger trial examining the efficacy of empiric antifungal treatment in patients with a clinical suspicion of ventilator-associated pneumonia and Candida in the endotracheal secretions. The presence of Candida in the lung may be associated with persistent inflammation and immunosuppression. More... »

PAGES

1313-1322

References to SciGraph publications

  • 2009-04-09. Significance of the isolation of Candida species from airway samples in critically ill patients: a prospective, autopsy study in INTENSIVE CARE MEDICINE
  • 2010-12-10. Immunoparalysis and nosocomial infection in children with multiple organ dysfunction syndrome in INTENSIVE CARE MEDICINE
  • 2006-11-08. Impact of antifungal treatment on Candida–Pseudomonas interaction: a preliminary retrospective case–control study in INTENSIVE CARE MEDICINE
  • 2013-10-11. Nebulised amphotericin B to eradicate Candida colonisation from the respiratory tract in critically ill patients receiving selective digestive decontamination: a cohort study in CRITICAL CARE
  • 2012-06-15. Candida colonization in ventilated ICU patients: no longer a bystander! in INTENSIVE CARE MEDICINE
  • 2012-06-15. Candida spp. airway colonization could promote antibiotic-resistant bacteria selection in patients with suspected ventilator-associated pneumonia in INTENSIVE CARE MEDICINE
  • 2010-12-14. The relationship between Candida species cultured from the respiratory tract and systemic inflammation in critically ill patients with ventilator-associated pneumonia in JOURNAL CANADIEN D'ANESTHÉSIE
  • 2013-10-09. A research agenda on the management of intra-abdominal candidiasis: results from a consensus of multinational experts in INTENSIVE CARE MEDICINE
  • 2012-06-30. Value of β-d-glucan and Candida albicans germ tube antibody for discriminating between Candida colonization and invasive candidiasis in patients with severe abdominal conditions in INTENSIVE CARE MEDICINE
  • 2011-06-20. Short term Candida albicans colonization reduces Pseudomonas aeruginosa-related lung injury and bacterial burden in a murine model in CRITICAL CARE
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00134-014-3352-2

    DOI

    http://dx.doi.org/10.1007/s00134-014-3352-2

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1001966514

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/24981955


    Indexing Status Check whether this publication has been indexed by Scopus and Web Of Science using the SN Indexing Status Tool
    Incoming Citations Browse incoming citations for this publication using opencitations.net

    JSON-LD is the canonical representation for SciGraph data.

    TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

    [
      {
        "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
        "about": [
          {
            "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/11", 
            "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
            "name": "Medical and Health Sciences", 
            "type": "DefinedTerm"
          }, 
          {
            "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1102", 
            "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
            "name": "Cardiorespiratory Medicine and Haematology", 
            "type": "DefinedTerm"
          }, 
          {
            "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1103", 
            "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
            "name": "Clinical Sciences", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Antifungal Agents", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Bronchoalveolar Lavage Fluid", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Candida", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Candidiasis", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Critical Illness", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Double-Blind Method", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Female", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Humans", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Male", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Middle Aged", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Pilot Projects", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Pneumonia, Ventilator-Associated", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Prospective Studies", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Respiratory System", 
            "type": "DefinedTerm"
          }
        ], 
        "author": [
          {
            "affiliation": {
              "alternateName": "D\u00e9partement de M\u00e9decine, Centre de recherche de l\u2019H\u00f4pital du Sacr\u00e9-Coeur de Montr\u00e9al, Universit\u00e9 de Montr\u00e9al, 5400 Gouin Ouest, Montreal, Canada", 
              "id": "http://www.grid.ac/institutes/grid.414056.2", 
              "name": [
                "D\u00e9partement de M\u00e9decine, Centre de recherche de l\u2019H\u00f4pital du Sacr\u00e9-Coeur de Montr\u00e9al, Universit\u00e9 de Montr\u00e9al, 5400 Gouin Ouest, Montreal, Canada"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Albert", 
            "givenName": "Martin", 
            "id": "sg:person.0675430015.19", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0675430015.19"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "D\u00e9partement de Pharmacie, Centre de recherche de l\u2019H\u00f4pital du Sacr\u00e9-Coeur de Montr\u00e9al, Universit\u00e9 de Montr\u00e9al, Montreal, Canada", 
              "id": "http://www.grid.ac/institutes/grid.414056.2", 
              "name": [
                "D\u00e9partement de Pharmacie, Centre de recherche de l\u2019H\u00f4pital du Sacr\u00e9-Coeur de Montr\u00e9al, Universit\u00e9 de Montr\u00e9al, Montreal, Canada"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Williamson", 
            "givenName": "David", 
            "id": "sg:person.01365714423.46", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01365714423.46"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Kingston General Hospital, Kingston, ON, Canada", 
              "id": "http://www.grid.ac/institutes/grid.415354.2", 
              "name": [
                "Kingston General Hospital, Kingston, ON, Canada"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Muscedere", 
            "givenName": "John", 
            "id": "sg:person.01015756545.95", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01015756545.95"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "D\u00e9partements de m\u00e9decine et d\u2019anesth\u00e9siologie, Division de soins intensifs adultes, Centre de recherche du Centre Hospitalier affili\u00e9 Universitaire de Qu\u00e9bec, Universit\u00e9 Laval, Quebec, Canada", 
              "id": "http://www.grid.ac/institutes/grid.23856.3a", 
              "name": [
                "D\u00e9partements de m\u00e9decine et d\u2019anesth\u00e9siologie, Division de soins intensifs adultes, Centre de recherche du Centre Hospitalier affili\u00e9 Universitaire de Qu\u00e9bec, Universit\u00e9 Laval, Quebec, Canada"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Lauzier", 
            "givenName": "Francois", 
            "id": "sg:person.01066142337.60", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01066142337.60"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Division of Infectious Diseases, Department of Medicine, University Health Network, University of Toronto, Toronto General Hospital, Toronto, Canada", 
              "id": "http://www.grid.ac/institutes/grid.17063.33", 
              "name": [
                "Division of Infectious Diseases, Department of Medicine, University Health Network, University of Toronto, Toronto General Hospital, Toronto, Canada"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Rotstein", 
            "givenName": "Coleman", 
            "id": "sg:person.01015727037.87", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01015727037.87"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "The Ottawa Hospital Research Institute, Ottawa, Canada", 
              "id": "http://www.grid.ac/institutes/grid.412687.e", 
              "name": [
                "The Ottawa Hospital Research Institute, Ottawa, Canada"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Kanji", 
            "givenName": "Salmaan", 
            "id": "sg:person.01207613372.27", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01207613372.27"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Clinical Evaluation Research Unit, Queen\u2019s University, Kingston General Hospital, Kingston, ON, Canada", 
              "id": "http://www.grid.ac/institutes/grid.415354.2", 
              "name": [
                "Clinical Evaluation Research Unit, Queen\u2019s University, Kingston General Hospital, Kingston, ON, Canada"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Jiang", 
            "givenName": "Xuran", 
            "id": "sg:person.0643562321.00", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0643562321.00"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Department of Pediatrics, Critical Care Medicine, Nationwide Children\u2019s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA", 
              "id": "http://www.grid.ac/institutes/grid.261331.4", 
              "name": [
                "Department of Pediatrics, Critical Care Medicine, Nationwide Children\u2019s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Hall", 
            "givenName": "Mark", 
            "id": "sg:person.0660745046.78", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0660745046.78"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Clinical Evaluation Research Unit, Queen\u2019s University, Kingston General Hospital, Kingston, ON, Canada", 
              "id": "http://www.grid.ac/institutes/grid.415354.2", 
              "name": [
                "Kingston General Hospital, Kingston, ON, Canada", 
                "Clinical Evaluation Research Unit, Queen\u2019s University, Kingston General Hospital, Kingston, ON, Canada"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Heyland", 
            "givenName": "Daren", 
            "id": "sg:person.01025111410.85", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01025111410.85"
            ], 
            "type": "Person"
          }
        ], 
        "citation": [
          {
            "id": "sg:pub.10.1186/cc10276", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1008807571", 
              "https://doi.org/10.1186/cc10276"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00134-012-2584-2", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1001590750", 
              "https://doi.org/10.1007/s00134-012-2584-2"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00134-010-2088-x", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1019231458", 
              "https://doi.org/10.1007/s00134-010-2088-x"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00134-009-1482-8", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1052801059", 
              "https://doi.org/10.1007/s00134-009-1482-8"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00134-012-2587-z", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1017576454", 
              "https://doi.org/10.1007/s00134-012-2587-z"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s12630-010-9439-5", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1003835127", 
              "https://doi.org/10.1007/s12630-010-9439-5"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1186/cc13056", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1027484617", 
              "https://doi.org/10.1186/cc13056"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00134-013-3109-3", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1007488628", 
              "https://doi.org/10.1007/s00134-013-3109-3"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00134-006-0422-0", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1019331264", 
              "https://doi.org/10.1007/s00134-006-0422-0"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00134-012-2616-y", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1022897831", 
              "https://doi.org/10.1007/s00134-012-2616-y"
            ], 
            "type": "CreativeWork"
          }
        ], 
        "datePublished": "2014-07-01", 
        "datePublishedReg": "2014-07-01", 
        "description": "PurposeCandida spp. are frequently recovered from endotracheal secretions in critically ill patients suspected of having ventilator-associated pneumonia. Observational studies reported an association with worse clinical outcomes but the effect of antifungal therapy in these patients remains unclear. We designed this pilot study to assess the feasibility of a larger trial and to evaluate inflammatory profiles and clinical outcomes in these patients.MethodsWe conducted a double-blind, placebo-controlled, multicenter pilot randomized trial of antifungal therapy in critically ill patients with a clinical suspicion of ventilator-associated pneumonia with positive airway secretion specimens for Candida spp. We also included an observational group without Candida spp. in their airway secretions. We measured recruitment rate, inflammatory and innate immune function profiles over time, and clinical outcomes.ResultsWe recruited 60 patients into the randomized trial and 29 patients into the observational study. Markers of inflammation and all clinical outcomes were comparable between placebo and antifungal treatment group at baseline and over time. At baseline, plasma TNF-\u03b1 levels were higher in patients with VAP and Candida compared to the observational group (mean\u00a0\u00b1\u00a0SD) (21.8\u00a0\u00b1\u00a023.1 versus 12.4\u00a0\u00b1\u00a09.3\u00a0pg/ml, p\u00a0=\u00a00.02) and these patients had lower innate immune function as evidenced by reduced whole blood ex vivo LPS-induced TNF-\u03b1 production capacity (854.8\u00a0\u00b1\u00a0855.2 versus 1,559.4\u00a0\u00b1\u00a01,290.6\u00a0pg/ml, p\u00a0=\u00a00.01).ConclusionsThis study does not provide evidence to support a larger trial examining the efficacy of empiric antifungal treatment in patients with a clinical suspicion of ventilator-associated pneumonia and Candida in the endotracheal secretions. The presence of Candida in the lung may be associated with persistent inflammation and immunosuppression.", 
        "genre": "article", 
        "id": "sg:pub.10.1007/s00134-014-3352-2", 
        "inLanguage": "en", 
        "isAccessibleForFree": false, 
        "isPartOf": [
          {
            "id": "sg:journal.1313639", 
            "issn": [
              "0342-4642", 
              "1432-1238"
            ], 
            "name": "Intensive Care Medicine", 
            "publisher": "Springer Nature", 
            "type": "Periodical"
          }, 
          {
            "issueNumber": "9", 
            "type": "PublicationIssue"
          }, 
          {
            "type": "PublicationVolume", 
            "volumeNumber": "40"
          }
        ], 
        "keywords": [
          "ventilator-associated pneumonia", 
          "clinical outcomes", 
          "ill patients", 
          "endotracheal secretions", 
          "clinical suspicion", 
          "large trials", 
          "antifungal therapy", 
          "antifungal treatment", 
          "observational study", 
          "observational group", 
          "lower innate immune function", 
          "Candida spp", 
          "empiric antifungal treatment", 
          "worse clinical outcomes", 
          "markers of inflammation", 
          "respiratory tract secretions", 
          "presence of Candida", 
          "innate immune function", 
          "antifungal treatment group", 
          "multicenter pilot", 
          "Randomized Placebo", 
          "airway secretions", 
          "inflammatory profile", 
          "persistent inflammation", 
          "vivo LPS", 
          "secretion specimens", 
          "tract secretions", 
          "pilot trial", 
          "treatment groups", 
          "immune function", 
          "patients", 
          "pneumonia", 
          "pilot study", 
          "trials", 
          "whole blood", 
          "secretion", 
          "ConclusionsThis study", 
          "placebo", 
          "outcomes", 
          "inflammation", 
          "TNF", 
          "therapy", 
          "suspicion", 
          "baseline", 
          "Candida", 
          "function profile", 
          "treatment", 
          "group", 
          "recruitment rates", 
          "immunosuppression", 
          "lung", 
          "LPS", 
          "study", 
          "MethodsWe", 
          "blood", 
          "VAP", 
          "efficacy", 
          "markers", 
          "association", 
          "profile", 
          "ResultsWe", 
          "spp", 
          "evidence", 
          "levels", 
          "specimens", 
          "time", 
          "rate", 
          "effect", 
          "pilot", 
          "presence", 
          "function", 
          "feasibility", 
          "impact", 
          "capacity", 
          "production capacity", 
          "positive airway secretion specimens", 
          "airway secretion specimens", 
          "innate immune function profiles", 
          "immune function profiles", 
          "reduced whole blood"
        ], 
        "name": "Candida in the respiratory tract secretions of critically ill patients and the impact of antifungal treatment: a randomized placebo controlled pilot trial (CANTREAT study)", 
        "pagination": "1313-1322", 
        "productId": [
          {
            "name": "dimensions_id", 
            "type": "PropertyValue", 
            "value": [
              "pub.1001966514"
            ]
          }, 
          {
            "name": "doi", 
            "type": "PropertyValue", 
            "value": [
              "10.1007/s00134-014-3352-2"
            ]
          }, 
          {
            "name": "pubmed_id", 
            "type": "PropertyValue", 
            "value": [
              "24981955"
            ]
          }
        ], 
        "sameAs": [
          "https://doi.org/10.1007/s00134-014-3352-2", 
          "https://app.dimensions.ai/details/publication/pub.1001966514"
        ], 
        "sdDataset": "articles", 
        "sdDatePublished": "2021-12-01T19:30", 
        "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
        "sdPublisher": {
          "name": "Springer Nature - SN SciGraph project", 
          "type": "Organization"
        }, 
        "sdSource": "s3://com-springernature-scigraph/baseset/20211201/entities/gbq_results/article/article_621.jsonl", 
        "type": "ScholarlyArticle", 
        "url": "https://doi.org/10.1007/s00134-014-3352-2"
      }
    ]
     

    Download the RDF metadata as:  json-ld nt turtle xml License info

    HOW TO GET THIS DATA PROGRAMMATICALLY:

    JSON-LD is a popular format for linked data which is fully compatible with JSON.

    curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1007/s00134-014-3352-2'

    N-Triples is a line-based linked data format ideal for batch operations.

    curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1007/s00134-014-3352-2'

    Turtle is a human-readable linked data format.

    curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1007/s00134-014-3352-2'

    RDF/XML is a standard XML format for linked data.

    curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1007/s00134-014-3352-2'


     

    This table displays all metadata directly associated to this object as RDF triples.

    317 TRIPLES      22 PREDICATES      131 URIs      112 LITERALS      21 BLANK NODES

    Subject Predicate Object
    1 sg:pub.10.1007/s00134-014-3352-2 schema:about N37b71779593e42ee8c7e5725beaf2252
    2 N37fc882aaaff417aa0032190de85d8b5
    3 N3c89cad3980846f19c3acc351f061323
    4 N55c5c7711fc94e3ab3e5d45726033f3c
    5 N5a2e397fd9e34ebeaa29dce978283122
    6 N6ff37952b363428b8b8ae24fc7a22e54
    7 N715b60b9ee9740a59048e4259479b698
    8 N7825b632927647348c92f88001cf5f63
    9 N79583992745b46bb9cb15f94cbba0bf6
    10 N7a49edd06b0e44fdb6e9e925d66b102f
    11 N7b241a4e380b44e7ac2213651656ebe0
    12 N8f4bc8dc3ed94fa2a07ea2f79ac8b2f1
    13 Nb7fa3a734e914b9f9123f4e14df21212
    14 Nf92f81ce044d4a45a0dea02ab80cb457
    15 anzsrc-for:11
    16 anzsrc-for:1102
    17 anzsrc-for:1103
    18 schema:author N3fc756d02932427fbb88e6f341abf3f5
    19 schema:citation sg:pub.10.1007/s00134-006-0422-0
    20 sg:pub.10.1007/s00134-009-1482-8
    21 sg:pub.10.1007/s00134-010-2088-x
    22 sg:pub.10.1007/s00134-012-2584-2
    23 sg:pub.10.1007/s00134-012-2587-z
    24 sg:pub.10.1007/s00134-012-2616-y
    25 sg:pub.10.1007/s00134-013-3109-3
    26 sg:pub.10.1007/s12630-010-9439-5
    27 sg:pub.10.1186/cc10276
    28 sg:pub.10.1186/cc13056
    29 schema:datePublished 2014-07-01
    30 schema:datePublishedReg 2014-07-01
    31 schema:description PurposeCandida spp. are frequently recovered from endotracheal secretions in critically ill patients suspected of having ventilator-associated pneumonia. Observational studies reported an association with worse clinical outcomes but the effect of antifungal therapy in these patients remains unclear. We designed this pilot study to assess the feasibility of a larger trial and to evaluate inflammatory profiles and clinical outcomes in these patients.MethodsWe conducted a double-blind, placebo-controlled, multicenter pilot randomized trial of antifungal therapy in critically ill patients with a clinical suspicion of ventilator-associated pneumonia with positive airway secretion specimens for Candida spp. We also included an observational group without Candida spp. in their airway secretions. We measured recruitment rate, inflammatory and innate immune function profiles over time, and clinical outcomes.ResultsWe recruited 60 patients into the randomized trial and 29 patients into the observational study. Markers of inflammation and all clinical outcomes were comparable between placebo and antifungal treatment group at baseline and over time. At baseline, plasma TNF-α levels were higher in patients with VAP and Candida compared to the observational group (mean ± SD) (21.8 ± 23.1 versus 12.4 ± 9.3 pg/ml, p = 0.02) and these patients had lower innate immune function as evidenced by reduced whole blood ex vivo LPS-induced TNF-α production capacity (854.8 ± 855.2 versus 1,559.4 ± 1,290.6 pg/ml, p = 0.01).ConclusionsThis study does not provide evidence to support a larger trial examining the efficacy of empiric antifungal treatment in patients with a clinical suspicion of ventilator-associated pneumonia and Candida in the endotracheal secretions. The presence of Candida in the lung may be associated with persistent inflammation and immunosuppression.
    32 schema:genre article
    33 schema:inLanguage en
    34 schema:isAccessibleForFree false
    35 schema:isPartOf N334ce9c4866e42df83aa1c91045cc8b0
    36 Nf83d3edf54e6492b80bba331fcaad882
    37 sg:journal.1313639
    38 schema:keywords Candida
    39 Candida spp
    40 ConclusionsThis study
    41 LPS
    42 MethodsWe
    43 Randomized Placebo
    44 ResultsWe
    45 TNF
    46 VAP
    47 airway secretion specimens
    48 airway secretions
    49 antifungal therapy
    50 antifungal treatment
    51 antifungal treatment group
    52 association
    53 baseline
    54 blood
    55 capacity
    56 clinical outcomes
    57 clinical suspicion
    58 effect
    59 efficacy
    60 empiric antifungal treatment
    61 endotracheal secretions
    62 evidence
    63 feasibility
    64 function
    65 function profile
    66 group
    67 ill patients
    68 immune function
    69 immune function profiles
    70 immunosuppression
    71 impact
    72 inflammation
    73 inflammatory profile
    74 innate immune function
    75 innate immune function profiles
    76 large trials
    77 levels
    78 lower innate immune function
    79 lung
    80 markers
    81 markers of inflammation
    82 multicenter pilot
    83 observational group
    84 observational study
    85 outcomes
    86 patients
    87 persistent inflammation
    88 pilot
    89 pilot study
    90 pilot trial
    91 placebo
    92 pneumonia
    93 positive airway secretion specimens
    94 presence
    95 presence of Candida
    96 production capacity
    97 profile
    98 rate
    99 recruitment rates
    100 reduced whole blood
    101 respiratory tract secretions
    102 secretion
    103 secretion specimens
    104 specimens
    105 spp
    106 study
    107 suspicion
    108 therapy
    109 time
    110 tract secretions
    111 treatment
    112 treatment groups
    113 trials
    114 ventilator-associated pneumonia
    115 vivo LPS
    116 whole blood
    117 worse clinical outcomes
    118 schema:name Candida in the respiratory tract secretions of critically ill patients and the impact of antifungal treatment: a randomized placebo controlled pilot trial (CANTREAT study)
    119 schema:pagination 1313-1322
    120 schema:productId N32f586d5840947dfbab47f165aa77d89
    121 N63375bcb6c65404486e2919679137b05
    122 N6e44f01b13fe40998c6a18895d4ba80b
    123 schema:sameAs https://app.dimensions.ai/details/publication/pub.1001966514
    124 https://doi.org/10.1007/s00134-014-3352-2
    125 schema:sdDatePublished 2021-12-01T19:30
    126 schema:sdLicense https://scigraph.springernature.com/explorer/license/
    127 schema:sdPublisher N3cbc39a7f5bc4a1b8374d8865fcf789e
    128 schema:url https://doi.org/10.1007/s00134-014-3352-2
    129 sgo:license sg:explorer/license/
    130 sgo:sdDataset articles
    131 rdf:type schema:ScholarlyArticle
    132 N32f586d5840947dfbab47f165aa77d89 schema:name dimensions_id
    133 schema:value pub.1001966514
    134 rdf:type schema:PropertyValue
    135 N334ce9c4866e42df83aa1c91045cc8b0 schema:volumeNumber 40
    136 rdf:type schema:PublicationVolume
    137 N37b71779593e42ee8c7e5725beaf2252 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    138 schema:name Antifungal Agents
    139 rdf:type schema:DefinedTerm
    140 N37fc882aaaff417aa0032190de85d8b5 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    141 schema:name Critical Illness
    142 rdf:type schema:DefinedTerm
    143 N3c89cad3980846f19c3acc351f061323 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    144 schema:name Bronchoalveolar Lavage Fluid
    145 rdf:type schema:DefinedTerm
    146 N3cbc39a7f5bc4a1b8374d8865fcf789e schema:name Springer Nature - SN SciGraph project
    147 rdf:type schema:Organization
    148 N3fc756d02932427fbb88e6f341abf3f5 rdf:first sg:person.0675430015.19
    149 rdf:rest Nc53963d6e6f84d93a3d0ddfd690e3bf1
    150 N4beff734a7e147968d5ea3981f3e6976 rdf:first sg:person.0643562321.00
    151 rdf:rest Ne8f7433ddf904470ad9f4629cafc70b7
    152 N52c6427cc0234d4c874fad2c3d34640f rdf:first sg:person.01015727037.87
    153 rdf:rest N7c7526ff02fa40b38f54c63224ee0785
    154 N55c5c7711fc94e3ab3e5d45726033f3c schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    155 schema:name Middle Aged
    156 rdf:type schema:DefinedTerm
    157 N5a2e397fd9e34ebeaa29dce978283122 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    158 schema:name Prospective Studies
    159 rdf:type schema:DefinedTerm
    160 N63375bcb6c65404486e2919679137b05 schema:name doi
    161 schema:value 10.1007/s00134-014-3352-2
    162 rdf:type schema:PropertyValue
    163 N6e44f01b13fe40998c6a18895d4ba80b schema:name pubmed_id
    164 schema:value 24981955
    165 rdf:type schema:PropertyValue
    166 N6ff37952b363428b8b8ae24fc7a22e54 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    167 schema:name Candida
    168 rdf:type schema:DefinedTerm
    169 N715b60b9ee9740a59048e4259479b698 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    170 schema:name Respiratory System
    171 rdf:type schema:DefinedTerm
    172 N7825b632927647348c92f88001cf5f63 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    173 schema:name Pneumonia, Ventilator-Associated
    174 rdf:type schema:DefinedTerm
    175 N79583992745b46bb9cb15f94cbba0bf6 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    176 schema:name Male
    177 rdf:type schema:DefinedTerm
    178 N7a49edd06b0e44fdb6e9e925d66b102f schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    179 schema:name Pilot Projects
    180 rdf:type schema:DefinedTerm
    181 N7b241a4e380b44e7ac2213651656ebe0 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    182 schema:name Female
    183 rdf:type schema:DefinedTerm
    184 N7c7526ff02fa40b38f54c63224ee0785 rdf:first sg:person.01207613372.27
    185 rdf:rest N4beff734a7e147968d5ea3981f3e6976
    186 N8f4bc8dc3ed94fa2a07ea2f79ac8b2f1 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    187 schema:name Humans
    188 rdf:type schema:DefinedTerm
    189 Nb7fa3a734e914b9f9123f4e14df21212 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    190 schema:name Double-Blind Method
    191 rdf:type schema:DefinedTerm
    192 Nc53963d6e6f84d93a3d0ddfd690e3bf1 rdf:first sg:person.01365714423.46
    193 rdf:rest Ne8b649f017f54c19b07e9a140f3e890b
    194 Ncbe910c4fad64343b53bf633b6173eb7 rdf:first sg:person.01025111410.85
    195 rdf:rest rdf:nil
    196 Ne581a955ef744329ab1b810528140f29 rdf:first sg:person.01066142337.60
    197 rdf:rest N52c6427cc0234d4c874fad2c3d34640f
    198 Ne8b649f017f54c19b07e9a140f3e890b rdf:first sg:person.01015756545.95
    199 rdf:rest Ne581a955ef744329ab1b810528140f29
    200 Ne8f7433ddf904470ad9f4629cafc70b7 rdf:first sg:person.0660745046.78
    201 rdf:rest Ncbe910c4fad64343b53bf633b6173eb7
    202 Nf83d3edf54e6492b80bba331fcaad882 schema:issueNumber 9
    203 rdf:type schema:PublicationIssue
    204 Nf92f81ce044d4a45a0dea02ab80cb457 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    205 schema:name Candidiasis
    206 rdf:type schema:DefinedTerm
    207 anzsrc-for:11 schema:inDefinedTermSet anzsrc-for:
    208 schema:name Medical and Health Sciences
    209 rdf:type schema:DefinedTerm
    210 anzsrc-for:1102 schema:inDefinedTermSet anzsrc-for:
    211 schema:name Cardiorespiratory Medicine and Haematology
    212 rdf:type schema:DefinedTerm
    213 anzsrc-for:1103 schema:inDefinedTermSet anzsrc-for:
    214 schema:name Clinical Sciences
    215 rdf:type schema:DefinedTerm
    216 sg:journal.1313639 schema:issn 0342-4642
    217 1432-1238
    218 schema:name Intensive Care Medicine
    219 schema:publisher Springer Nature
    220 rdf:type schema:Periodical
    221 sg:person.01015727037.87 schema:affiliation grid-institutes:grid.17063.33
    222 schema:familyName Rotstein
    223 schema:givenName Coleman
    224 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01015727037.87
    225 rdf:type schema:Person
    226 sg:person.01015756545.95 schema:affiliation grid-institutes:grid.415354.2
    227 schema:familyName Muscedere
    228 schema:givenName John
    229 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01015756545.95
    230 rdf:type schema:Person
    231 sg:person.01025111410.85 schema:affiliation grid-institutes:grid.415354.2
    232 schema:familyName Heyland
    233 schema:givenName Daren
    234 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01025111410.85
    235 rdf:type schema:Person
    236 sg:person.01066142337.60 schema:affiliation grid-institutes:grid.23856.3a
    237 schema:familyName Lauzier
    238 schema:givenName Francois
    239 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01066142337.60
    240 rdf:type schema:Person
    241 sg:person.01207613372.27 schema:affiliation grid-institutes:grid.412687.e
    242 schema:familyName Kanji
    243 schema:givenName Salmaan
    244 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01207613372.27
    245 rdf:type schema:Person
    246 sg:person.01365714423.46 schema:affiliation grid-institutes:grid.414056.2
    247 schema:familyName Williamson
    248 schema:givenName David
    249 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01365714423.46
    250 rdf:type schema:Person
    251 sg:person.0643562321.00 schema:affiliation grid-institutes:grid.415354.2
    252 schema:familyName Jiang
    253 schema:givenName Xuran
    254 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0643562321.00
    255 rdf:type schema:Person
    256 sg:person.0660745046.78 schema:affiliation grid-institutes:grid.261331.4
    257 schema:familyName Hall
    258 schema:givenName Mark
    259 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0660745046.78
    260 rdf:type schema:Person
    261 sg:person.0675430015.19 schema:affiliation grid-institutes:grid.414056.2
    262 schema:familyName Albert
    263 schema:givenName Martin
    264 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0675430015.19
    265 rdf:type schema:Person
    266 sg:pub.10.1007/s00134-006-0422-0 schema:sameAs https://app.dimensions.ai/details/publication/pub.1019331264
    267 https://doi.org/10.1007/s00134-006-0422-0
    268 rdf:type schema:CreativeWork
    269 sg:pub.10.1007/s00134-009-1482-8 schema:sameAs https://app.dimensions.ai/details/publication/pub.1052801059
    270 https://doi.org/10.1007/s00134-009-1482-8
    271 rdf:type schema:CreativeWork
    272 sg:pub.10.1007/s00134-010-2088-x schema:sameAs https://app.dimensions.ai/details/publication/pub.1019231458
    273 https://doi.org/10.1007/s00134-010-2088-x
    274 rdf:type schema:CreativeWork
    275 sg:pub.10.1007/s00134-012-2584-2 schema:sameAs https://app.dimensions.ai/details/publication/pub.1001590750
    276 https://doi.org/10.1007/s00134-012-2584-2
    277 rdf:type schema:CreativeWork
    278 sg:pub.10.1007/s00134-012-2587-z schema:sameAs https://app.dimensions.ai/details/publication/pub.1017576454
    279 https://doi.org/10.1007/s00134-012-2587-z
    280 rdf:type schema:CreativeWork
    281 sg:pub.10.1007/s00134-012-2616-y schema:sameAs https://app.dimensions.ai/details/publication/pub.1022897831
    282 https://doi.org/10.1007/s00134-012-2616-y
    283 rdf:type schema:CreativeWork
    284 sg:pub.10.1007/s00134-013-3109-3 schema:sameAs https://app.dimensions.ai/details/publication/pub.1007488628
    285 https://doi.org/10.1007/s00134-013-3109-3
    286 rdf:type schema:CreativeWork
    287 sg:pub.10.1007/s12630-010-9439-5 schema:sameAs https://app.dimensions.ai/details/publication/pub.1003835127
    288 https://doi.org/10.1007/s12630-010-9439-5
    289 rdf:type schema:CreativeWork
    290 sg:pub.10.1186/cc10276 schema:sameAs https://app.dimensions.ai/details/publication/pub.1008807571
    291 https://doi.org/10.1186/cc10276
    292 rdf:type schema:CreativeWork
    293 sg:pub.10.1186/cc13056 schema:sameAs https://app.dimensions.ai/details/publication/pub.1027484617
    294 https://doi.org/10.1186/cc13056
    295 rdf:type schema:CreativeWork
    296 grid-institutes:grid.17063.33 schema:alternateName Division of Infectious Diseases, Department of Medicine, University Health Network, University of Toronto, Toronto General Hospital, Toronto, Canada
    297 schema:name Division of Infectious Diseases, Department of Medicine, University Health Network, University of Toronto, Toronto General Hospital, Toronto, Canada
    298 rdf:type schema:Organization
    299 grid-institutes:grid.23856.3a schema:alternateName Départements de médecine et d’anesthésiologie, Division de soins intensifs adultes, Centre de recherche du Centre Hospitalier affilié Universitaire de Québec, Université Laval, Quebec, Canada
    300 schema:name Départements de médecine et d’anesthésiologie, Division de soins intensifs adultes, Centre de recherche du Centre Hospitalier affilié Universitaire de Québec, Université Laval, Quebec, Canada
    301 rdf:type schema:Organization
    302 grid-institutes:grid.261331.4 schema:alternateName Department of Pediatrics, Critical Care Medicine, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
    303 schema:name Department of Pediatrics, Critical Care Medicine, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
    304 rdf:type schema:Organization
    305 grid-institutes:grid.412687.e schema:alternateName The Ottawa Hospital Research Institute, Ottawa, Canada
    306 schema:name The Ottawa Hospital Research Institute, Ottawa, Canada
    307 rdf:type schema:Organization
    308 grid-institutes:grid.414056.2 schema:alternateName Département de Médecine, Centre de recherche de l’Hôpital du Sacré-Coeur de Montréal, Université de Montréal, 5400 Gouin Ouest, Montreal, Canada
    309 Département de Pharmacie, Centre de recherche de l’Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, Canada
    310 schema:name Département de Médecine, Centre de recherche de l’Hôpital du Sacré-Coeur de Montréal, Université de Montréal, 5400 Gouin Ouest, Montreal, Canada
    311 Département de Pharmacie, Centre de recherche de l’Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, Canada
    312 rdf:type schema:Organization
    313 grid-institutes:grid.415354.2 schema:alternateName Clinical Evaluation Research Unit, Queen’s University, Kingston General Hospital, Kingston, ON, Canada
    314 Kingston General Hospital, Kingston, ON, Canada
    315 schema:name Clinical Evaluation Research Unit, Queen’s University, Kingston General Hospital, Kingston, ON, Canada
    316 Kingston General Hospital, Kingston, ON, Canada
    317 rdf:type schema:Organization
     




    Preview window. Press ESC to close (or click here)


    ...