Management of central venous catheters in patients with cancer and candidemia
Abstract
To determine the need and appropriate timing of catheter removal in patients with candidemia, the records for 404 patients with cancer and central venous catheters (CVCs) who developed candidemia during the period of 1993-1998 were retrospectively reviewed. Of the total 404 cases of candidemia, 241 (60%) were due to a primary source, 111 (27%) were catheter related, and 52 (13%) were secondary cases of candidemia caused by a source other than the catheter. Multivariate analysis showed that catheter removal < or =72 h after onset improved response to antifungal therapy exclusively in patients with catheter-related candidemia (P=.04). Clinical characteristics that suggested a noncatheter source for the candidemia were disseminated infection (P<.01), previous chemotherapy (P<.01), previous corticosteroid therapy (P=.02), and poor response to antifungal therapy (P<.03). CVC removal < or =72 h after onset should be considered in patients with suspected catheter-related candidemia who have no evidence of dissemination, recent corticosteroid therapy, or chemotherapy.
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Venous catheter infection and IC guidelines, including the current IDSA guidelines, recommend removal of any intravascular catheter that is positive for a fungal pathogen (i.e., Candida) based on evidence from large retrospective and observational studies.
“Venous catheter infection and IC guidelines, including the current IDSA guidelines, recommend removal of any intravascular catheter that is positive for a fungal pathogen (ie, Candida) based on evidence from large retrospective and observational studies.”
From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [175]
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- Authors
- Raad, I., Hanna, H., Boktour, M., Girgawy, E., Danawi, H., Mardani, M., Kontoyiannis, D., Darouiche, R., Hachem, R., & Bodey, G. P.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- The University of Texas Health Science Center at Houston (US)
- Baylor College of Medicine (US)
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2004-04-15
- Volume
- 38
- Issue
- 8
- Pages
- 1119-1127
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2141022761
- Cited by
- 159
- References
- 45
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 4 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 9 · 2019: 9 · 2018: 6 · 2017: 4 · 2016: 7 · 2015: 4 · 2014: 10 · 2013: 11 · 2012: 11
- FWCI
- 5.50
- 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
- central venous catheters, candidemia, catheter-related candidemia, catheter removal timing, cancer patients, antifungal therapy response, systemic candidiasis, corticosteroid therapy, chemotherapy, catheter-related bloodstream infection
- MeSH terms
- Candidiasis, Catheterization, Central Venous, Female, Humans, Male, Middle Aged, Neoplasms, Retrospective Studies, Multivariate Analysis, Prosthesis-Related Infections, Fungemia
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