Journal Article

Should Vascular Catheters Be Removed from All Patients with Candidemia? An Evidence-Based Review

Marcio Nucci and Elias Anaissie

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 5, pages 591-599
Published in print March 2002 | ISSN: 1058-4838
Published online March 2002 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/338714
Should Vascular Catheters Be Removed from All Patients with Candidemia? An Evidence-Based Review

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The removal of all central venous catheters (CVCs) from all patients with candidemia is considered to be standard care. However, this practice is not always possible, and it is associated with significant cost and potential complications. To evaluate the effect of CVC removal on the outcome of patients with candidemia, a literature review was conducted that selected studies that evaluated CVC removal as a prognostic factor (of mortality) in candidemia, performed a multivariate analysis with odds ratios and 95% confidence intervals, and included a validated severity of illness score. Of 203 studies of candidemia, only 4 fulfilled these criteria. One study showed a benefit from CVC removal in a subset of 21 neutropenic patients; another study showed no benefit; and the remaining 2 studies showed a marginal benefit from this strategy. Although it is possible that removal of CVCs may reduce the rate of complications due to candidemia, including death, the findings of this literature review do not substantiate this consensus recommendation.

Journal Article.  4400 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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