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Cited by 178Antifungal resistance and susceptibilityInfective Endocarditis Diagnosis and ManagementFungal Infections and Studies

Risk factors for death in patients with candidemia

Nucci, Marcio, Colombo, Arnaldo L., Silveira, Fernanda, Richtmann, Rosana, Salomão, Reinaldo, Branchini, Maria Luiza, Spector, Nelson·1998·Infection Control & Hospital Epidemiology
DOI 10.1086/647743
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Abstract

Objective: To analyze possible risk factors for death among patients with nosocomial candidemia. To identify risk factors for death in patients with candidemia, we analyzed demographic, clinical, and microbiological data. Setting: Six tertiary hospitals in Brazil. Patients: A cohort of 145 patients with candidemia. Design: 26 possible risk factors for death, including age, underlying disease, signs of deep-seated infection, neutropenia, number of positive blood cultures, removal of a central venous catheter, etiologic agent of the candidemia, susceptibility pattern of the isolate to amphotericin B, and antifungal treatment were evaluated by univariate stepwise logistic regression analysis. Results: Non- albicans species accounted for 63.4% of the candidemias. Risk factors for death in univariate analysis were older age, catheter retention, poor performance status, candidemia due to species other than Candida parapsilosis , hypotension, candidemia due to species other than Candida parapsilosis , and no antifungal treatment. In multivariate analysis, older age and non-removal of a central venous catheter were the only factors associated with an increased risk for death. Conclusions: These data suggest that patients with candidemia and a central venous catheter should have the catheter removed.

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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 [172]

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Authors
Nucci, M., Colombo, A. L., Silveira, F., Richtmann, R., Salomão, R., Branchini, M. L., & Spector, N.
Affiliations
  • Universidade Federal do Rio de Janeiro
  • Universidade Federal do Rio de Janeiro (BR)
  • Universidade Estadual de Campinas
ORCID
Venue
Infection Control & Hospital Epidemiology
Publisher
Cambridge University Press (CUP)
Published
1998-11
Volume
19
Issue
11
Pages
846-850
ISSN
  • 0899-823X (ISSN-L)
  • 1559-6834
DOI
10.1086/647743
OpenAlex
W1990685201
Cited by
178
References
27
Citations by year
2025: 1 · 2024: 2 · 2023: 1 · 2021: 2 · 2020: 3 · 2019: 1 · 2018: 5 · 2017: 2 · 2016: 2 · 2015: 5 · 2014: 6 · 2013: 12 · 2012: 10
FWCI
5.27
Type
journal article
Language
en
Open access
closed
Licence
www.cambridge.org/core/terms (unspecified, 6360 d)
Locations
  • Infection Control and Hospital Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
  • Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords
candidemia, nosocomial candidemia, mortality risk factors, central venous catheters, catheter removal, Candida parapsilosis, non-albicans Candida, age, antifungal therapy, amphotericin B susceptibility, neutropenia, hypotension
MeSH terms
Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Brazil, Candidiasis, Child, Child, Preschool, Cross Infection, Female, Hospitals, Public, Humans, Infant, Infant, Newborn, Male, Middle Aged, Prospective Studies, Risk Factors

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