Should Vascular Catheters Be Removed from All Patients with Candidemia? An Evidence-Based Review
Abstract
The removal of all central venous catheters (CVCs) from all patients with candidemia is considered to be standard care. However, this practice is not always possible, and it is associated with significant cost and potential complications. To evaluate the effect of CVC removal on the outcome of patients with candidemia, a literature review was conducted that selected studies that evaluated CVC removal as a prognostic factor (of mortality) in candidemia, performed a multivariate analysis with odds ratios and 95% confidence intervals, and included a validated severity of illness score. Of 203 studies of candidemia, only 4 fulfilled these criteria. One study showed a benefit from CVC removal in a subset of 21 neutropenic patients; another study showed no benefit; and the remaining 2 studies showed a marginal benefit from this strategy. Although it is possible that removal of CVCs may reduce the rate of complications due to candidemia, including death, the findings of this literature review do not substantiate this consensus recommendation.
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There are no randomized studies of catheter removal for candidemia, and a recent exhaustive review demonstrates the limitations of the available data.
“There are, however, no randomized studies of this topic, and a recent exhaustive review [119] clearly demonstrates the limitations of the available data.”
From Guidelines for Treatment of Candidiasis (2004) · cites this paper as [119]
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- Authors
- Nucci, M., & Anaissie, E.
- Affiliations
- Universidade Federal do Rio de Janeiro (BR)
- University of Arkansas for Medical Sciences (US)
- Corresponding author
- Anaissie, E.
- ORCID
- Nucci, M.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2002-03-01
- Volume
- 34
- Issue
- 5
- Pages
- 591-599
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2097503946
- Cited by
- 175
- References
- 37
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2022: 2 · 2021: 4 · 2020: 2 · 2019: 4 · 2018: 2 · 2017: 3 · 2016: 7 · 2015: 5 · 2014: 5 · 2013: 1 · 2012: 13
- FWCI
- 11.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Health Professions › Emergency Medical Services › Central Venous Catheters and Hemodialysis
- Health Sciences › Medicine › Oncology › Neutropenia and Cancer Infections
- Keywords
- candidemia, central venous catheter removal, catheter-related bloodstream infection, mortality, prognostic factors, neutropenic patients, fungemia, disease severity index
- MeSH terms
- Candidiasis, Catheters, Indwelling, Humans, Multivariate Analysis, Odds Ratio, Prosthesis-Related Infections, Evidence-Based Medicine, Device Removal
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