Journal
INTENSIVE CARE MEDICINE
Volume 35, Issue 4, Pages 707-712Publisher
SPRINGER
DOI: 10.1007/s00134-009-1431-6
Keywords
Central vascular catheters; Candidemia; Invasive candidiasis; Catheter tip colonization; Antifungal agents; Critically ill patients
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Funding
- Fundacion para la Investigacion Biomedica del Hospital General Universitario Gregorio Maranon
- Fondo de Investigacion Sanitaria (FIS) [CM06/00037, CM05/00171]
- Espanola de Investigacion en Patologia Infecciosa (REIPI) [RD06/0008/1025]
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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.
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