TY - JOUR
T1 - Management of central venous catheters in patients with cancer and candidemia
AU - Raad, Issam
AU - Hanna, Hend
AU - Boktour, Maha
AU - Girgawy, Essam
AU - Danawi, Hadi
AU - Mardani, Masoud
AU - Kontoyiannis, Dimitrios
AU - Darouiche, Rabih
AU - Hachem, Ray
AU - Bodey, Gerald P.
PY - 2004/4/15
Y1 - 2004/4/15
N2 - To determine the need and appropriate timing of catheter removal in patients with candidemia, the records for 404 patients with cancer and central venous catheters (CVCs) who developed candidemia during the period of 1993-1998 were retrospectively reviewed. Of the total 404 cases of candidemia, 241 (60%) were due to a primary source, 111 (27%) were catheter related, and 52 (13%) were secondary cases of candidemia caused by a source other than the catheter. Multivariate analysis showed that catheter removal ≤72 h after onset improved response to antifungal therapy exclusively in patients with catheter-related candidemia (P = .04). Clinical characteristics that suggested a noncatheter source for the candidemia were disseminated infection (P < .01), previous chemotherapy (P < .01), previous corticosteroid therapy (P = .02), and poor response to antifungal therapy (P < .03). CVC removal ≤72 h after onset should be considered in patients with suspected catheter-related candidemia who have no evidence of dissemination, recent corticosteroid therapy, or chemotherapy.
AB - To determine the need and appropriate timing of catheter removal in patients with candidemia, the records for 404 patients with cancer and central venous catheters (CVCs) who developed candidemia during the period of 1993-1998 were retrospectively reviewed. Of the total 404 cases of candidemia, 241 (60%) were due to a primary source, 111 (27%) were catheter related, and 52 (13%) were secondary cases of candidemia caused by a source other than the catheter. Multivariate analysis showed that catheter removal ≤72 h after onset improved response to antifungal therapy exclusively in patients with catheter-related candidemia (P = .04). Clinical characteristics that suggested a noncatheter source for the candidemia were disseminated infection (P < .01), previous chemotherapy (P < .01), previous corticosteroid therapy (P = .02), and poor response to antifungal therapy (P < .03). CVC removal ≤72 h after onset should be considered in patients with suspected catheter-related candidemia who have no evidence of dissemination, recent corticosteroid therapy, or chemotherapy.
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U2 - 10.1086/382874
DO - 10.1086/382874
M3 - Review article
C2 - 15095217
AN - SCOPUS:2342481897
SN - 1058-4838
VL - 38
SP - 1119
EP - 1127
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 8
ER -