Predictors of Candida spp. as causative agents of catheter-related bloodstream infections

摘要

We conducted this study to identify risk factors that may predict whether Candida spp. are causative agents of suspected catheter-related bloodstream infections (CRBSIs). All patients with laboratory-confirmed CRBSIs at Kyoto University Hospital between 2009 and 2011 were included. We compared the clinical features of candidal CRBSIs (78 cases) and non-candidal CRBSIs (258 cases). According to a multivariate analysis, a solid tumor (odds ratio [OR], 3.11; 95% confidence interval [CI], 1.75-5.53), total parental nutrition (OR, 2.65; 95% CI, 1.39-5.06), and the administration of anti-anaerobic agents (OR, 2.22; 95% CI, 1.03-4.79) were significantly more common among candidal CRBSIs. The (1,3)-beta-D-glucan (BDG) test was positive among 94.6% (35/37) of candidal CRBSI patients and 9.4% (10/106) of non-candidal CRBSI cases. The administration of antifungal agents may be considered for patients with these risk factors, especially when the BDG test is positive. (C) 2014 Elsevier Inc. All rights reserved.