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Risk Factors for Death in Patients With Candidemia

1998; Cambridge University Press; Volume: 19; Issue: 11 Linguagem: Inglês

10.1086/647743

1559-6834

Márcio Nucci, Arnaldo Lopes Colombo, Fernanda Silveira, Rosana Richtmann, Reinaldo Salomão, Maria Luíza Moretti Branchini, Nelson Spector,

Central Venous Catheters and Hemodialysis

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.