Clinical features of catheter-related candidemia at disease onset

Yoshino Y, Wakabayashi Y, Suzuki S, Seo K, Koga I, Kitazawa T, Okugawa S, Ota Y
Correspondence: Dr Yusuke Yoshino, yoshinosuke0618@gmail.com

ABSTRACT
INTRODUCTION Early detection of catheter-related candidemia is necessary to ensure that patients receive prompt and appropriate treatment. The aim of the present case-control study is to investigate the clinical features of catheter-related candidemia at disease onset, so as to determine the clinical indications for empiric antifungal therapy.
METHODS All 41 cases of catheter-related candidemia from September 2009 to August 2011 at a teaching hospital were included in the present study. To determine the characteristics that were risk factors for developing catheter-related candidemia, we compared all cases of catheter-related candidemia with all 107 cases of catheter-related blood stream infection (CRBSI) caused by non-Candida spp.
RESULTS In comparison with CRBSI due to non-Candida spp., the duration of catheter use was significantly longer in cases of catheter-related candidemia (13.9 ± 9.0 days vs. 23.2 ± 25.2 days). There was also a significant difference in the frequency of pre-antibiotic treatment between catheter-related candidemia and CRBSI due to non-Candida spp. (97.6% [40/41 cases] vs. 44.9% [48/107 cases]). Patients with catheter-related candidemia also had significantly more severe clinical statuses (measured using the Sepsis-related Organ Failure Assessment score) than patients with CRBSI due to non-Candida spp. (7.63 ± 3.65 vs. 5.92 ± 2.81).
CONCLUSION When compared to patients with CRBSI caused by non-Candida spp., patients with catheter-related candidemia had significantly more severe clinical backgrounds, longer duration of catheter use and more frequent prior administration of antibiotic agents.

Keywords: candidemia, catheter-related bloodstream infection, clinical feature
Singapore Med J 2014; 55(11): 579-582; http://dx.doi.org/10.11622/smedj.2014154

http://smj.org.sg/sites/default/files/5511/5511a3.pdf

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