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Erschienen in:
01.04.2009 | Brief Report
Is Candida colonization of central vascular catheters in non-candidemic, non-neutropenic patients an indication for antifungals?
Erschienen in: Intensive Care Medicine | Ausgabe 4/2009
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Purpose
To assess the influence of antifungal therapy on the outcome of non-candidemic adult patients with central vascular catheter (CVC) tips colonized by Candida species.
Methods
A retrospective analysis of the outcome of patients with Candida colonization of their CVC tip and no concurrent candidemia was made over a 4-year period. Patients who either died or developed candidemia-invasive candidiasis (poor outcome) were compared with those who improved.
Results
We finally included 58 patients for analysis. Almost all (91.4%) had to be admitted to the ICU during their hospital stay. Independent predictors for outcome were a McCabe and Jackson score corresponding to ultimately fatal underlying disease [odds ratio (OR) 11.98; 95% confidence interval (CI), 1.37–104.97; P = 0.02], and maximum severity corresponding to severe sepsis, septic shock or multiorgan failure (OR: 6.16, CI 95%: 1.00–37.93; P = 0.05). We were unable to demonstrate that antifungal therapy was an independent variable influencing outcome (OR 0.82; 95% CI, 0.27–2.47; P = 0.73).
Conclusions
Our data suggest that, in non-neutropenic critically ill patients with no concomitant candidemia and with CVC tips colonized by Candida, antifungal therapy does not seem to have a significant influence on clinical outcome.