Cited by 179Antifungal resistance and susceptibilityCentral Venous Catheters and HemodialysisNeonatal and Maternal Infections

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Should central venous catheters be removed as soon as candidemia is detected in neonates

Karlowicz, M. Gary, Hashimoto, Laura Nickles, Kelly, Robert E., Buescher, E. Stephen·2000·Pediatrics

DOI 10.1542/peds.106.5.e63

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Abstract

Background Controversy exists regarding the most appropriate acute management of central venous catheters (CVCs) in neonates with candidemia, with up to two thirds of neonatologists preferring to attempt antifungal therapy without removing CVCs. Objective To determine whether CVCs should be removed as soon as candidemia is detected in neonates. Methods. A cohort study of candidemia and CVC was conducted in infants in a neonatal intensive care unit (NICU) over a 5-year period (1994-1998). Results Fifty infants had early-removal CVC (ER-CVC) within 3 days and 54 infants had late-removal CVC (LR-CVC) >3 days after the first positive blood culture for Candida species. All infants were treated with amphotericin B. There was no significant difference between infants in the ER-CVC and LR-CVC groups in terms of gender, ethnicity, birth weight, gestational age, age at candidemia, severity-of-illness scores, distribution of types of CVC, or in the distribution of Candida species causing candidemia. The ER-CVC group had significantly shorter duration of candidemia (median: 3 days; range: 1-14 days), compared with the LR-CVC group (median: 6 days; range: 1-24 days). The case fatality rate of Candida albicans candidemia was significantly affected by the timing of CVC removal: 0 of 21 (95% confidence interval [CI]: 0-14) infants died in the ER-CVC group in contrast to 9 of 23 (39%; 95% CI: 19-59) in the LR-CVC group. Conclusion Failure to remove CVC as soon as candidemia was detected in ne…

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Authors: Karlowicz, M. G., Hashimoto, L. N., Kelly, R. E., & Buescher, E. S.
Affiliations: From the Departments of Pediatrics and
Eastern Virginia Medical School (US)
ORCID: Kelly, Robert E.
Venue: Pediatrics
Publisher: American Academy of Pediatrics (AAP)
Published: 2000-11-01
Volume: 106
Issue: 5
Pages: e63-e63
ISSN: 0031-4005 (ISSN-L)
1098-4275
DOI: 10.1542/peds.106.5.e63
OpenAlex: W2057232181
Cited by: 178
References: 17
Citations by year: 2026: 2 · 2025: 5 · 2024: 5 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 3 · 2018: 5 · 2017: 4 · 2016: 5 · 2015: 7 · 2014: 8 · 2013: 11 · 2012: 8
FWCI: 4.11
Type: journal article
Language: en
Open access: closed
Locations: PEDIATRICS (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Central Venous Catheters and Hemodialysis
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and Maternal Infections
Keywords: candidemia, central venous catheters, neonates, catheter removal timing, Candida albicans, amphotericin B, case fatality rate, neonatal intensive care, antifungal therapy
MeSH terms: Candida, Candidiasis, Catheterization, Central Venous, Humans, Infant, Newborn, Intensive Care Units, Neonatal

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Should central venous catheters be removed as soon as candidemia is detected in neonates

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