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Clinical significance of Candida colonization of intravascular catheters in the absence of documented candidemia [artículo]

Por: Aguado García, José María [Enfermedades Infecciosas] | Chaves Sánchez, Fernando [Microbiología y Parasitología] | Fernández Ruiz, Mario [Medicina Interna] | López Medrano, Francisco [Enfermedades Infecciosas] | Origüen Sabater, Julia [Enfermedades Infecciosas] | Panizo Mota, Fernando [Enfermedades Infecciosas] | San Juan Garrido, Rafael [Medicina Interna] | Sanz Sanz, Francisca [Microbiología y Parasitología].
Colaborador(es): Servicio de Medicina Interna | Servicio de Microbiología y Parasitología | Instituto de Investigación imas12.
Editor: Diagnostic Microbiology and Infectious Disease, 2012Descripción: 73(2):157-161.Recursos en línea: Solicitar documento Resumen: In order to assess the significance of Candida colonization of intravascular catheters (IVC) in patients without documented candidemia, we retrospectively reviewed all Candida-positive IVC tip cultures over a 4-year period. Cases were defined as those with a culture yielding ≥15 colony-forming units of Candida spp. that either did not have blood cultures (BC) taken or had concomitant BC negative for Candida. Patients were followed up until death or 8 months after discharge. Risk factors for poor outcome following IVC removal (death, candidemia, or Candida-related complication) were analyzed. We analyzed a total of 40 patients. Overall mortality was 40.0%, with no death directly attributed to Candida infection. Twenty-two patients received antifungal therapy at the time of IVC removal. Only 1 patient developed a metastatic complication (chorioretinitis) attributable to transient candidemia (2.5% of the global cohort and 3.7% among those with concomitant BC). There were no cases of subsequent candidemia. In the multivariate analysis, the use of antifungal therapy did not show any impact on the risk of poor outcome. The risk of invasive disease in patients with isolated IVC colonization by Candida seems to be low. Nevertheless, the initiation of systemic antifungal therapy should be carefully considered in such context.
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Artículo Artículo PC658 (Navegar estantería) Disponible

Formato Vancouver:
López-Medrano F, Fernández-Ruiz M, Origüen J, Belarte-Tornero LC, Carazo-Medina R, Panizo-Mota F, et al. Clinical significance of Candida colonization of intravascular catheters in the absence of documented candidemia. Diagn Microbiol Infect Dis. 2012;73(2):157-61.

PMID: 22483190

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In order to assess the significance of Candida colonization of intravascular catheters (IVC) in patients without documented candidemia, we retrospectively reviewed all Candida-positive IVC tip cultures over a 4-year period. Cases were defined as those with a culture yielding ≥15 colony-forming units of Candida spp. that either did not have blood cultures (BC) taken or had concomitant BC negative for Candida. Patients were followed up until death or 8 months after discharge. Risk factors for poor outcome following IVC removal (death, candidemia, or Candida-related complication) were analyzed. We analyzed a total of 40 patients. Overall mortality was 40.0%, with no death directly attributed to Candida infection. Twenty-two patients received antifungal therapy at the time of IVC removal. Only 1 patient developed a metastatic complication (chorioretinitis) attributable to transient candidemia (2.5% of the global cohort and 3.7% among those with concomitant BC). There were no cases of subsequent candidemia. In the multivariate analysis, the use of antifungal therapy did not show any impact on the risk of poor outcome. The risk of invasive disease in patients with isolated IVC colonization by Candida seems to be low. Nevertheless, the initiation of systemic antifungal therapy should be carefully considered in such context.

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