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Risk Factors for Death in Patients With Candidemia

Published online by Cambridge University Press:  31 March 2016

Marcio Nucci ,
Arnaldo L. Colombo ,
Fernanda Silveira ,
Rosana Richtmann ,
Reinaldo Salomão ,
Maria Luiza Branchini  and
Nelson Spector
Marcio Nucci*
Affiliation:
Department of Internal Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro
Arnaldo L. Colombo
Affiliation:
Department of Medicine, Escola Paulista de Medicina—UNIFESP
Fernanda Silveira
Affiliation:
Hospital Universitário, Universidade Federal do Rio de Janeiro, Rio de Janeiro
Rosana Richtmann
Affiliation:
Division of Infectious Diseases, Hospital do Srevidor Público Estadual
Reinaldo Salomão
Affiliation:
Department of Medicine, Escola Paulista de Medicina—UNIFESP Division of Infectious Diseases, Casa de Saúde e Maternidade Santa Marcelina, São Paulo
Maria Luiza Branchini
Affiliation:
Department of Internal Medicine, Universidade Estadual de Campinas, Campinas, Brazil
Nelson Spector
Affiliation:
Department of Internal Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro
*
Serviço de Hematologia, Hospital Universitário Clementino Fraga Filho, Av Brigadeiro Trompovsky s/n CEP 21941-590 Rio de Janeiro, Brasil; e-mail, mnucci@plugue.com.br
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Abstract

Objective:

To analyze possible risk factors for death among patients with nosocomial candidemia. To identify risk factors for death in patients with candidemia, we analyzed demographic, clinical, and microbiological data.

Setting:

Six tertiary hospitals in Brazil.

Patients:

A cohort of 145 patients with candidemia.

Design:

26 possible risk factors for death, including age, underlying disease, signs of deep-seated infection, neutropenia, number of positive blood cultures, removal of a central venous catheter, etiologic agent of the candidemia, susceptibility pattern of the isolate to amphotericin B, and antifungal treatment were evaluated by univariate stepwise logistic regression analysis.

Results:

Non-albicans species accounted for 63.4% of the candidemias. Risk factors for death in univariate analysis were older age, catheter retention, poor performance status, candidemia due to species other than Candida parapsilosis, hypotension, candidemia due to species other than Candida parapsilosis, and no antifungal treatment. In multivariate analysis, older age and non-removal of a central venous catheter were the only factors associated with an increased risk for death.

Conclusions:

These data suggest that patients with candidemia and a central venous catheter should have the catheter removed.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 19 , Issue 11 , November 1998 , pp. 846 - 850
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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