Candidemia in non-neutropenic patients with an intravenous hyperalimentation catheter: good prognosis of Candida parapsilosis infection.
Positive blood cultures reported between 1986 and 1993 at the Tokyo Metropolitan Komagome Hospital were evaluated and all patients with an intravenous hyperalimentation catheter who developed candidemia, a total of 94 patients, were analyzed further, while patients with neutropenia were excluded. The primary diagnosis was malignancy in 87.2% of the cases, and Candida albicans and C. parapsilosis were the main organisms detected. A total of 17 patients died from candidemia. The patients who were positive for C. parapsilosis, however, all survived in spite of the fact that their main treatment was only removal of the catheter (20/32 cases), while eight of 25 patients who developed fungemia due to C. albicans died from the fungemia (p = 0.001). There were no significant differences in their risk factors. Because of the better outcome for the patients who developed candidemia due to C. parapsilosis, we might be able to consider less aggressive treatment for such patients.
Kataoka
S
S
Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Japan.
Kashiwa
M
M
Saku
K
K
Handa
N
N
Akiyama
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002177:Candidiasis / Q000209:etiology*; D002404:Catheterization / Q000009:adverse effects*; D004866:Equipment Contamination; D016469:Fungemia / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D009503:Neutropenia; D010289:Parenteral Nutrition, Total / Q000009:adverse effects* / Q000295:instrumentation; D011379:Prognosis; D012307:Risk Factors