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Management of central venous catheters in patients with cancer and candidemia.

Abstract
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 < or =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 < or =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.
AuthorsIssam Raad, Hend Hanna, Maha Boktour, Essam Girgawy, Hadi Danawi, Masoud Mardani, Dimitrios Kontoyiannis, Rabih Darouiche, Ray Hachem, Gerald P Bodey
JournalClinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 38 Issue 8 Pg. 1119-27 (Apr 15 2004) ISSN: 1537-6591 [Electronic] United States
PMID15095217 (Publication Type: Journal Article)
Topics
  • Candidiasis (complications, mortality)
  • Catheterization, Central Venous (adverse effects)
  • Female
  • Fungemia (complications)
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms (complications)
  • Prosthesis-Related Infections (complications, microbiology)
  • Retrospective Studies

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