Ana Paula Jafet Ourives1, Sarah Santos Gonçalves1, Ricardo Andreotti Siqueira1, Ana Carolina Remondi Souza1, Maria Eugenia F Canziani2, Silvia Regina Manfredi3, Luci Correa4, Arnaldo Lopes Colombo5. 1. Laboratório Especial de Micologia, Disciplina de Infectologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil. 2. Disciplina de Nefrologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil. 3. Hospital do Rim e Hipertensão-Fundação Oswaldo Ramos, Brazil. 4. Hospital Israelita Albert Einstein, Brazil and Escola Paulista de Medicina, Universidade Federal de São Paulo, SP, Brazil. 5. Laboratório Especial de Micologia, Disciplina de Infectologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil. Electronic address: arnaldolcolombo@gmail.com.
Abstract
BACKGROUND: Hemodialysis has been described as an important risk factor for the development of candidemia in patients suffering from chronic renal failure. AIMS: The aim of this study was to evaluate the epidemiology of candidemia in outpatients with renal replacement therapy (RRT) by hemodialysis where the fungemia clearly represents a healthcare-associated infection. METHODS: We retrospectively collected clinical and laboratory data from patients undergoing at least 3 months of RRT by hemodialysis who developed candidemia within 48h of hospital admission. RESULTS: We identified 14 patients with candidemia with central venous catheters (CVC) in place for 11-277 days before developing fungemia. Deep-seated infection was documented in 6 out of 14 candidiasis cases (43%), including 5 cases of endocarditis (36%). CONCLUSIONS: CVC in patients under RRT should be promptly replaced by fistulas and grafts to avoid bloodstream infections. Facing a case of candidemia, adequate source control and prompt initiation of antifungal therapy are mandatory to avoid morbidity and mortality.
BACKGROUND: Hemodialysis has been described as an important risk factor for the development of candidemia in patients suffering from chronic renal failure. AIMS: The aim of this study was to evaluate the epidemiology of candidemia in outpatients with renal replacement therapy (RRT) by hemodialysis where the fungemia clearly represents a healthcare-associated infection. METHODS: We retrospectively collected clinical and laboratory data from patients undergoing at least 3 months of RRT by hemodialysis who developed candidemia within 48h of hospital admission. RESULTS: We identified 14 patients with candidemia with central venous catheters (CVC) in place for 11-277 days before developing fungemia. Deep-seated infection was documented in 6 out of 14 candidiasis cases (43%), including 5 cases of endocarditis (36%). CONCLUSIONS: CVC in patients under RRT should be promptly replaced by fistulas and grafts to avoid bloodstream infections. Facing a case of candidemia, adequate source control and prompt initiation of antifungal therapy are mandatory to avoid morbidity and mortality.
Authors: Joo Hui Kim; Min Jeong Kim; Byung-Min Ye; June Hyun Kim; Min Jeong Kim; Seorin Kim; Il Young Kim; Hyo Jin Kim; Miyeun Han; Harin Rhee; Sang Heon Song; Eun Young Seong; Soo Bong Lee; Dong Won Lee Journal: Kidney Res Clin Pract Date: 2020-09-30