title: No evidence of increased ocular involvement in candidemic patients initially treated with echinocandins.
abstract: Candins are commonly used as initial therapy in patients with candidemia and are known to diffuse poorly into ocular tissue. The aim of our multicenter study was to assess whether eye involvement was more common in patients initially treated with echinocandins. We performed a post hoc analysis of a prospective, multicenter, population-based candidemic surveillance program implemented in Spain during 2010-2011 (CANDIPOP project). Eye involvement was detected in 13 of 168 patients with candidemia (7.7%) who underwent ophthalmoscopy. Two patients had endophthalmitis, while the remaining patients had chorioretinitis. The frequency of ocular candidiasis was similar in patients receiving initial therapy with candins (3/56; 5.4%) or with other regimens (10/112; 8.9%). At multivariate analysis, risk conditions for eye involvement were dialysis after candidemia (OR, 19.4; 95% CI, 1.7-218.4) and involvement of organs other than the eye (OR, 5.4; 95% CI, 1.1-25.7). In conclusion, eye involvement was not found to be more frequent in patients receiving initial therapy with echinocandins than in patients receiving other drugs.
authors.affiliation: Clinical Microbiology and Infectious Disease Division, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Gregorio Marañón, Madrid, Spain; CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain. Electronic address: pmunoz@micro.hggm.es.
authors.forename: P
authors.initials: P
authors.lastname: Muñoz
authors.affiliation: Clinical Microbiology and Infectious Disease Division, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Gregorio Marañón, Madrid, Spain. Electronic address: anton.vena@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Vena
authors.affiliation: Clinical Microbiology and Infectious Disease Division, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Padilla
authors.affiliation: Clinical Microbiology and Infectious Disease Division, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Valerio
authors.affiliation: Hospital Majadahonda, Madrid, Spain.
authors.forename: M I
authors.initials: MI
authors.lastname: Sanchez
authors.affiliation: Hospital Universitario Vall D' Hebron, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Puig-Asensio
authors.affiliation: Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Fortún
authors.affiliation: Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Fernández-Ruiz
authors.affiliation: Hospital Clínico, Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Merino
authors.affiliation: Hospital de Alcorcón, Madrid, Spain.
authors.forename: J E
authors.initials: JE
authors.lastname: Losa
authors.affiliation: Hospital Universitario Virgen de Valme, Sevilla, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Loza
authors.affiliation: Hospital de Galdakano, Bilbao, Spain.
authors.forename: R A
authors.initials: RA
authors.lastname: Rivas
authors.affiliation: Clinical Microbiology and Infectious Disease Division, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Gregorio Marañón, Madrid, Spain; CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Bouza
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D058387:Candidemia / Q000188:drug therapy*; D002825:Chorioretinitis / Q000382:microbiology; D054714:Echinocandins / Q000627:therapeutic use*; D009877:Endophthalmitis / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013030:Spain
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins
keywords: Candida endophthalmitis; Echinocandins; Initial antifungal therapy