Publication: Prevalence of Ocular Candidiasis and Candida Endophthalmitis in Patients with Candidemia: A Systematic Review and Meta-Analysis
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Issued Date
2023
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application/pdf
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Scopus
Bibliographic Citation
Clinical Infectious Diseases. Vol 76, No.10 (2023), p.1738-1749
Suggested Citation
Phongkhun K., Pothikamjorn T., Srisurapanont K., Manothummetha K., Sanguankeo A., Thongkam A., Chuleerarux N., Leksuwankun S., Meejun T., Thanakitcharu J., Walker M., Gopinath S., Torvorapanit P., Langsiri N., Worasilchai N., Moonla C., Plongla R., Kates O.S., Nematollahi S., Permpalung N. Prevalence of Ocular Candidiasis and Candida Endophthalmitis in Patients with Candidemia: A Systematic Review and Meta-Analysis. Clinical Infectious Diseases. Vol 76, No.10 (2023), p.1738-1749. doi:10.1093/cid/ciad064 Retrieved from: https://hdl.handle.net/20.500.14740/12354
Other Contributor(s)
Abstract
Background. Infectious diseases and ophthalmology professional societies have disagreed regarding ocular screening in patients with candidemia. We aimed to summarize the current evidence on the prevalence of ocular candidiasis (OC) and Candida endophthalmitis (CE) according to the standardized definitions. Methods. A literature search was conducted from the inception date through 16 October 2022 using PubMed, Embase, and SCOPUS. Pooled prevalence of ocular complications was derived from generalized linear mixed models (PROSPERO CRD42022326610). Results. A total of 70 and 35 studies were included in the meta-analysis for OC and concordant CE (chorioretinitis with vitreous involvement), respectively. This study represented 8599 patients with candidemia who underwent ophthalmologic examination. Pooled prevalences (95% CI) of OC, overall CE, concordant CE, and discordant CE were 10.7% (8.4–13.5%), 3.1% (2.1–4.5%), 1.8% (1.3–2.6%), and 7.4% (4.5–12%) of patients screened, respectively. Studies from Asian countries had significantly higher concordant CE prevalence (95% CI) of patients screened (3.6%; 2.9–4.6%) compared with studies from European countries (1.4%; .4–5%) and American countries (1.4%; .9–2.2%) (P <.01). Presence of total parenteral nutrition and Candida albicans was associated with CE, with pooled odds ratios (95% CI) of 6.92 (3.58–13.36) and 3.02 (1.67–5.46), respectively. Conclusions. Prevalence of concordant CE overall and among Asian countries was 2 and 4 times higher than the prevalence previously reported by the American Academy of Ophthalmology (AAO) of <0.9%, respectively. There is an urgent need to study optimal screening protocols and to establish joint recommendations by the Infectious Diseases Society of America and AAO. © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved.