Predictors of Candida sp. as a causative agent of catheter-related bloodstream Infections

Ref ID: 18778

Author:

M. Nagao, PhD (Doctor of Philosophy), MD – Lecturer, G. Hotta, MD – Graduate student, M. Yamamoto, MD – Graduate student, Y. Matsumura, MD, PhD – Research associate, A. Matsushima, MD, PhD – Research associate, Y. Ito, MD, PhD – Research associate, S

Author address:

Kyoto Univ. Hosp., Kyoto, Japan.

Full conference title:

52nd Annual ICAAC

Date: 9 September 2014

Abstract:

Background: Candida bloodstream infection is associated with high morbidity and mortality in hospitalized patients. Most candida bloodstream infections are catheter related, but little is known about predictors of candidal catheter-related bloodstream infection (CRBSI). Objective: We conducted this study to determine risk factors that may predict Candida sp. as a causative agent among patients who were suspected to have a CRBSI. Methods: From January 2009 to December 2011, all patients with laboratory-confirmed CRBSI at Kyoto University Hospital were included in this study. We compared the clinical features of candidal CRBSIs and non-candidal CRBSIs. Results: We identified 78 candidal CRBSIs and 258 non-candidal CRBSIs. According to the univariate analysis, older age, solid malignancies, total parental nutrition, use of anti-anaerobic agents within 7 days, and placement of multiple intravenous/atrial catheters were common among candidal CRBSI, whereas hematological malignancies and post-transplantation status were less common (p<0.05). According to the multivariate analysis, solid malignancies (odds ratio (OR), 2.75; 95% confidence interval (CI), 1.54 - 4.90; p <0.001), total parental nutrition (OR, 2.86; 95% CI, 1.49 - 5.48; p =0.002), and use of anti-anaerobic agents (OR, 2.22; 95% CI, 1.03 - 4.79; p <0.001) were significantly more common among candidal CRBSI patients than among non-candidal CRBSI patients. The 1-3 β -D glucan test was positive among 94.5 % (35/37) of candidal CRBSI patients and 9% (10/106) of non-candidal CRBSI cases. Conclusion: Several factors such as solid malignancies, total parental nutrition and presence of multiple intravenous/atrial catheters may assist clinicians in assessing whether Candida sp. is a causative agent of CRBSI. Catheter removal and administration of antifungal agents may be considered for empiric therapy of CRBSI cases with those risk factors, especially when 1-3 β -D glucan tests are positive.

Abstract Number: K-949

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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