Journal Article

Management of Central Venous Catheters in Patients with Cancer and Candidemia

Issam Raad, Hend Hanna, Maha Boktour, Essam Girgawy, Hadi Danawi, Masoud Mardani, Dimitrios Kontoyiannis, Rabih Darouiche, Ray Hachem and Gerald P. Bodey

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 8, pages 1119-1127
Published in print April 2004 | ISSN: 1058-4838
Published online April 2004 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/382874
Management of Central Venous Catheters in Patients with Cancer and Candidemia

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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.

Journal Article.  4844 words.  Illustrated.

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

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