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.
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 illpatients with no concomitant candidemia and with CVC tips colonized by Candida, antifungal therapy does not seem to have a significant influence on clinical outcome.
Authors: Mitchell M Levy; Mitchell P Fink; John C Marshall; Edward Abraham; Derek Angus; Deborah Cook; Jonathan Cohen; Steven M Opal; Jean-Louis Vincent; Graham Ramsay Journal: Crit Care Med Date: 2003-04 Impact factor: 7.598
Authors: R Luzzati; G Amalfitano; L Lazzarini; F Soldani; S Bellino; M Solbiati; M C Danzi; S Vento; G Todeschini; C Vivenza; E Concia Journal: Eur J Clin Microbiol Infect Dis Date: 2000-08 Impact factor: 3.267
Authors: Miquel B Ekkelenkamp; Tjomme van der Bruggen; David A M C van de Vijver; Tom F W Wolfs; Marc J M Bonten Journal: Clin Infect Dis Date: 2008-01-01 Impact factor: 9.079
Authors: Pierre Emmanuel Charles; Jean Marc Doise; Jean Pierre Quenot; Hervé Aube; Frédéric Dalle; Pascal Chavanet; Nadine Milesi; Ludwig Serge Aho; Henri Portier; Bernard Blettery Journal: Intensive Care Med Date: 2003-09-10 Impact factor: 17.440
Authors: M Guembe; M Rodríguez-Créixems; P Martín-Rabadán; L Alcalá; P Muñoz; E Bouza Journal: Eur J Clin Microbiol Infect Dis Date: 2013-10-31 Impact factor: 3.267
Authors: Alexandra Fochtmann; Christina Forstner; Maike Keck; Gabriela Muschitz; Elisabeth Presterl; Gerald Ihra; Thomas Rath Journal: Intensive Care Med Date: 2015-04-09 Impact factor: 17.440
Authors: Massimo Antonelli; Elie Azoulay; Marc Bonten; Jean Chastre; Giuseppe Citerio; Giorgio Conti; Daniel De Backer; François Lemaire; Herwig Gerlach; Goran Hedenstierna; Michael Joannidis; Duncan Macrae; Jordi Mancebo; Salvatore M Maggiore; Alexandre Mebazaa; Jean-Charles Preiser; Jerôme Pugin; Jan Wernerman; Haibo Zhang Journal: Intensive Care Med Date: 2010-01-08 Impact factor: 17.440
Authors: Niccolò Buetti; Elia Lo Priore; Rami Sommerstein; Andrew Atkinson; Andreas Kronenberg; Jonas Marschall Journal: Crit Care Date: 2018-10-11 Impact factor: 9.097