A prospective cohort study evaluating the prognostic impact of clinical characteristics and comorbid conditions of hospitalized adult and pediatric cancer patients with candidemia
Abstract
The purpose of this study was to describe the clinical aspects of the epidemiology of candidemia and compare the prognostic impact of potential risk factors and the microbiology data of adults and children with cancer. A prospective cohort study enrolling 99 adults and 130 children with candidemia at a tertiary oncology care center in Brazil was undertaken. A total of 229 episodes were analyzed. The overall mortality was higher among adults than in children (37.4% vs. 7.7%, respectively). Univariate analysis revealed significant differences in the risk factors associated with death between both groups. Mortality was similar following fungemia with Candida albicans and all C. non-albicans species. However, significant differences in the interspecies distribution and death rates were observed, mainly among C. glabrata, krusei, and tropicalis species. Multivariate analysis showed comorbidities and neutropenia to be independently associated with mortality in adults, while in children, only comorbidities negatively affected the outcome. Comorbidities were the most important independent prognostic factor in both groups. The inclusion of detailed information about pre-existent illnesses might have a real benefit in studies of candidemia outcome.
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A few studies have questioned these recommendations, failing to find a significant mortality benefit with prompt removal of the line and advising that removal and placement of a new device does not come without risk and cost.
“A few studies have questioned these recommendations, failing to find a significant mortality benefit with prompt removal of the line and advising that removal and placement of a new device does not come without risk and cost.”
From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [181]
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- Authors
- Velasco, E., & Bigni, R.
- Affiliations
- Instituto Nacional de Câncer - INCA (BR)
- Corresponding author
- Velasco, E.
- ORCID
- Velasco, E.
- Venue
- European Journal of Clinical Microbiology & Infectious Diseases
- Published
- 2008-06-12
- Volume
- 27
- Issue
- 11
- Pages
- 1071-1078
- ISSN
- 0934-9723 (ISSN-L)
- 1435-4373
- OpenAlex
- W2072464950
- Cited by
- 59
- References
- 30
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 1 · 2022: 3 · 2021: 1 · 2020: 3 · 2019: 2 · 2018: 4 · 2017: 1 · 2016: 3 · 2015: 8 · 2014: 5 · 2013: 2 · 2012: 6
- FWCI
- 3.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Journal of Clinical Microbiology & Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Oncology › Neutropenia and Cancer Infections
- Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
- Keywords
- candidemia, fungemia, cancer patients, pediatric oncology, adult oncology, mortality, prognostic factors, comorbidities, neutropenia, Candida albicans, non-albicans Candida, Candida glabrata, Candida krusei, Candida tropicalis, risk factors
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Brazil, Candida, Candidiasis, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Neoplasms, Neutropenia, Prognosis, Prospective Studies, Risk Factors, Cohort Studies, Comorbidity, Fungemia
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