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Cited by 76Antifungal resistance and susceptibilityCentral Venous Catheters and HemodialysisInfective Endocarditis Diagnosis and Management

Impact of early central venous catheter removal on outcome in patients with candidaemia

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Rodriguez, D., Park, B.J., Almirante, B., Cuenca-Estrella, M., Planes, A.M., Mensa, J., Gimenez, M., Saballs, P. +3 more·2007·Clinical Microbiology and Infection
DOI 10.1111/j.1469-0691.2007.01758.x
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Abstract

Removal of central venous catheters (CVCs) from candidaemic patients is considered the reference standard of care, although this practice is not always possible. The impact of prompt catheter removal on outcome was investigated by analysing data from an active population-based surveillance study in Barcelona, Spain. Patients with candidaemia and a CVC were identified between January 2002 and December 2003. Cases with CVC removal within 2 days were classified as having early CVC removal. Outcome, defined as in-hospital mortality 2-30 days after diagnosis of candidaemia, was determined among hospitalised adults using univariate, Kaplan-Meier and multivariate logistic regression analysis. Outpatients, paediatric patients and those who died or were discharged within 2 days were excluded. The study identified 265 patients with candidaemia and a CVC. Median time from diagnosis of candidaemia to catheter removal was 1 day (range 0-29 days). Overall, 172 patients met the criteria for inclusion in the outcome study. Patients with early CVC removal differed significantly from those with delayed CVC removal. According to univariate, Kaplan-Meier and multivariate analysis, the marker most predictive of in-hospital mortality among candidaemic patients with CVCs was severity of illness. These data suggest that timing of CVC removal may best be determined after carefully considering the risks and benefits to individual patients.

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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 [180]

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Authors
Rodriguez, D., Park, B. J., Almirante, B., Cuenca-Estrella, M., Planes, A. M., Mensa, J., Gimenez, M., Saballs, P., Fridkin, S. K., Rodriguez-Tudela, J. L., & Pahissa, A.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • Universitat Autònoma de Barcelona (ES)
  • Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES)
  • Hospital Del Mar (ES)
ORCID
Venue
Clinical Microbiology and Infection
Publisher
Elsevier BV
Published
2007-08
Volume
13
Issue
8
Pages
788-793
ISSN
1198-743X (ISSN-L)
DOI
10.1111/j.1469-0691.2007.01758.x
OpenAlex
W2112179577
Cited by
76
References
23
Citations by year
2026: 4 · 2025: 1 · 2024: 3 · 2022: 4 · 2021: 2 · 2020: 5 · 2019: 3 · 2018: 2 · 2017: 2 · 2016: 6 · 2015: 2 · 2014: 9 · 2013: 4 · 2012: 8
FWCI
3.38
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Microbiology and Infection (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 › Epidemiology › Infective Endocarditis Diagnosis and Management
Keywords
candidemia, central venous catheter removal, in-hospital mortality, invasive candidiasis, disease severity, mortality risk factors, hospitalized adults
MeSH terms
Adult, Candidiasis, Catheterization, Central Venous, Cross Infection, Female, Humans, Male, Prospective Studies, Risk Factors, Severity of Illness Index, Spain, Fungemia, Hospital Mortality, APACHE, Kaplan-Meier Estimate

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