CAMEO-a cross-sectional survey study on candidemia management in Germany

Area of Science:

• Infectious Diseases
• Clinical Practice Research
• Healthcare Management

Background:

• Candida species cause severe bloodstream infections (candidemia), especially in vulnerable patients.
• Guideline adherence improves candidemia outcomes, but real-world implementation faces challenges.
• Optimizing management of invasive fungal infections is critical for patient survival.

Purpose of the Study:

• To assess current clinical practices and identify barriers in candidemia management in German healthcare institutions.
• To evaluate adherence to established guidelines for treating Candida bloodstream infections.
• To understand diagnostic and therapeutic strategies employed by physicians.

Main Methods:

• A cross-sectional, web-based survey using a questionnaire based on the EQUAL Candida score.
• Data collected from physicians on institutional characteristics, diagnostics, antifungal therapy, and follow-up.
• Descriptive statistics and chi-square testing were used for data analysis.

Main Results:

• Caspofungin was the primary first-line antifungal (81.4%), with limited use of fluconazole (5.3%).
• Routine echocardiography (57%) and ophthalmoscopy (37%) showed varied adherence.
• Timely central line management (82.5%) and follow-up blood cultures (daily 31.4%, every 48h 54.8%) were reported.

Conclusions:

• Core candidemia management practices are largely implemented in Germany.
• Underutilization of certain recommended diagnostic steps, like ophthalmoscopy, was observed.
• Targeted interventions are necessary to improve guideline adherence and patient outcomes.