title: Clinical significance of Candida colonization of intravascular catheters in the absence of documented candidemia.
abstract: In order to assess the significance of Candida colonization of intravascular catheters (IVC) in patients without documented candidemia, we retrospectively reviewed all Candida-positive IVC tip cultures over a 4-year period. Cases were defined as those with a culture yielding ≥15 colony-forming units of Candida spp. that either did not have blood cultures (BC) taken or had concomitant BC negative for Candida. Patients were followed up until death or 8 months after discharge. Risk factors for poor outcome following IVC removal (death, candidemia, or Candida-related complication) were analyzed. We analyzed a total of 40 patients. Overall mortality was 40.0%, with no death directly attributed to Candida infection. Twenty-two patients received antifungal therapy at the time of IVC removal. Only 1 patient developed a metastatic complication (chorioretinitis) attributable to transient candidemia (2.5% of the global cohort and 3.7% among those with concomitant BC). There were no cases of subsequent candidemia. In the multivariate analysis, the use of antifungal therapy did not show any impact on the risk of poor outcome. The risk of invasive disease in patients with isolated IVC colonization by Candida seems to be low. Nevertheless, the initiation of systemic antifungal therapy should be carefully considered in such context.
authors.affiliation: Unit of Infectious Diseases, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense, Madrid, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: López-Medrano
authors.forename: Mario
authors.initials: M
authors.lastname: Fernández-Ruiz
authors.forename: Julia
authors.initials: J
authors.lastname: Origüen
authors.forename: Laia C
authors.initials: LC
authors.lastname: Belarte-Tornero
authors.forename: Raquel
authors.initials: R
authors.lastname: Carazo-Medina
authors.forename: Fernando
authors.initials: F
authors.lastname: Panizo-Mota
authors.forename: Fernando
authors.initials: F
authors.lastname: Chaves
authors.forename: Francisca
authors.initials: F
authors.lastname: Sanz-Sanz
authors.forename: Rafael
authors.initials: R
authors.lastname: San Juan
authors.forename: José María
authors.initials: JM
authors.lastname: Aguado
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002175:Candida / Q000302:isolation & purification*; D058387:Candidemia / Q000209:etiology / Q000382:microbiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000382:microbiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors