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 Original Articles |
| Risk Factors and Prognosis for Persistent Candidemia without Catheter Colonization |
| Yun Tae Chae1, Su Jin Jeong2,3, Nam Su Ku2,3, Ji-Hyeon Baek2,3, Hyewon Kim2,3, Sun Bean Kim2, Ji Hyun Yoon2, Sung Joon Jin2, Sang Hoon Han2,3, Young Goo Song2,3, June Myung Kim2,3, and Jun Yong Choi2,3 |
| 1Department of Internal Medicine, KEPCO Medical Foundation Hanil General hospital, 2Department of Internal Medicine, and 3AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea |
Vol.43 Num.4 (p349~354)
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Background: Candidemia is one of the most common causes of nosocomial bloodstream infection, and increases the morbidity and mortality rate of seriously ill patients. We evaluated the risk factors and outcomes associated with persistent candidemia without catheter colonization (non-catheter related candidemia) and compared them with those of non-persistent candidemia.
Materials and Methods: A retrospective case-control study was performed to identify risk factors for, and outcomes of, persistent candidemia. All adults who experienced candidemia in a university-affiliated hospital in Korea between January 2005 and December 2009 were included. Patients with catheter colonization were excluded. Persistent candidemia was defined as the occurrence of candidemia in a patient receiving at least 3 days of systemic antifungal agents prior to the second positive blood culture.
Results: Of 605 adult patients with candidemia, 104 (17.2%) patients had persistent candidemia and 23 (3.8%) patients were free of catheter colonization. There were no statistically significant differences in baseline characteristics between patients with persistent and non-persistent candidemia. In univariate analysis, less use of metronidazole, glycopeptide, fluoroquinolone, and aminoglycoside, and presence of Candida parapsilosis were significantly associated with persistent candidemia. In multivariate analysis, less use of metronidazole was an independent factor
associated with persistent candidemia. The candidemia related mortality was insignificantly (P =0.094) higher in persistent candidemia than non-persistent candidemia.
Conclusions: Persistent candidemia can occur without catheterization. Patterns of antibiotic use could be associated with the occurrence of persistent candidemia, and prognosis of persistent candidemia seems to be worse than non-persistent candidemia. Further studies for persistent candidemia should be performed.
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Keywords : Candidemia, Risk factors, Mortality |
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