title: Prognostic factors of candidemia among nonneutropenic adults with total parenteral nutrition.
abstract: BACKGROUND
  Immediate removal of central venous catheters (CVCs) is not possible in patients with candidemia requiring total parenteral nutrition (TPN). This study analyzed the possible prognostic factors for survival time after onset of candidemia among nonneutropenic adults requiring TPN.
  
  
  METHODS
  We conducted a retrospective analysis from September 2003 to August 2005.
  
  
  RESULTS
  A total of 59 nonneutropenic adults with candidemia and requiring TPN were identified retrospectively. All Candida isolates were susceptible to flucytosine and amphotericin B. With the exception of one C glabrata isolate, all other isolates were susceptible to fluconazole and itraconazole. The only predictor of 30-day survival rate after onset of candidemia identified in our analysis was an Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 23 points or less. Adults with higher APACHE II scores, who did not have their CVCs changed, did not receive antifungal treatment, or who had thrombocytopenia had shorter survival times after the onset of candidemia.
  
  
  CONCLUSIONS
  APACHE II scores, thrombocytopenia, antifungal agents, and CVCs changes are associated with survival time in nonneutropenic adults requiring TPN after the onset of candidemia.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.
authors.forename: Chen-Chi
authors.initials: CC
authors.lastname: Tsai
authors.forename: Chorng-Jang
authors.initials: CJ
authors.lastname: Lay
authors.forename: Chun-Lung
authors.initials: CL
authors.lastname: Wang
authors.forename: Mei-Lin
authors.initials: ML
authors.lastname: Lin
authors.forename: Su-Pen
authors.initials: SP
authors.lastname: Yang
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000935:Antifungal Agents / Q000627:therapeutic use; D058387:Candidemia / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D016022:Case-Control Studies; D002405:Catheterization, Central Venous; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D011379:Prognosis; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000382:microbiology
chemical_list: D000935:Antifungal Agents