Candida colonization and systemic infection in neutropenic patients. A retrospective study.
The results of surveillance cultures in 424 neutropenic patients with hematologic malignancies were analyzed to evaluate the relationship between colonization and infection by Candida species. Eighteen (32%) of 56 patients with multiple noncontiguous colonized sites developed proven (13 cases) or probable (five cases) systemic candidiasis, versus two patients with proven candidiasis (1.2%) of 170 with one colonized site (P less than 0.00000001), and one patient with proven candidiasis (0.5%) of 198 without any evidence of Candida colonization (P less than 0.00000001). Twenty-two patients with multiple colonized sites who developed a febrile episode resistant to antibiotics were treated with empiric amphotericin B. Nine of 11 given empiric amphotericin B within day 6 survived versus three of 11 receiving antifungal therapy after day 6 (P = 0.014). The above data seem to justify further prospective studies on Candida colonization as indication to early antifungal therapy in febrile neutropenic patients.
Martino
P
P
Dipartimento di Biopatologia Umana, Universita' di Roma, Italia.
Girmenia
C
C
Venditti
M
M
Micozzi
A
A
Santilli
S
S
Burgio
V L
VL
Mandelli
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000380:Agranulocytosis / Q000382:microbiology*; D000666:Amphotericin B / Q000627:therapeutic use; D002177:Candidiasis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications / Q000382:microbiology*; D012189:Retrospective Studies
D000666:Amphotericin B