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16.05.2019 | Original Article | Ausgabe 8/2019

European Journal of Clinical Microbiology & Infectious Diseases 8/2019

Central venous catheter unrelated candidemia influences the outcome of infection in patients with solid tumors

European Journal of Clinical Microbiology & Infectious Diseases > Ausgabe 8/2019
Elena Orsetti, Lucia Brescini, Sara Mazzanti, Francesca Trave, Gianluca Morroni, Antonella Pocognoli, Rossana Berardi, Francesco Barchiesi
Wichtige Hinweise
Elena Orsetti and Lucia Brescini contributed equally to this work.

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Systemic infections due to Candida spp. is common among immunocompromised patients, including those with solid tumors (ST). Clinical characteristics of candidemia in 114 patients with ST were compared with those of 249 candidemic patients without ST (non-ST). Patients with ST were more likely to be hospitalized in medical departments, to have a significantly higher Charlson’s score and to undergo a significantly later central venous catheter (CVC) removal (P < 0.001). Similarly, the use of total parenteral nutrition was more common in ST patients (P = 0.026). Although there was a trend toward a more appropriate use of antifungal therapy in ST (60%) than in non-ST patients (49%), the difference was not statistically significant (P = 0.059). Thirty-day mortality was significantly higher in ST (49%) than in non-ST patients (36%, P = 0.016). Multivariate analysis showed that either higher age or septic shock was an independent risk factor for mortality in both groups of patients. Conversely, a CVC-unrelated candidemia represented an independent risk factor for mortality in ST patients (HR 3.581 [CI 95% 1.412–9.087, P = 0.007]). Overall, these data show that candidemia in ST patients is characterized by an extremely high mortality rate.

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