title: Predictors of Candida spp. as causative agents of catheter-related bloodstream infections.
abstract: 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)-β-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.
authors.affiliation: Department of Infection Control and Prevention, Kyoto University Hospital, Kyoto, Japan; Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. Electronic address: mnagao@kuhp.kyoto-u.ac.jp.
authors.forename: Miki
authors.initials: M
authors.lastname: Nagao
authors.affiliation: Department of Infection Control and Prevention, Kyoto University Hospital, Kyoto, Japan; Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Gou
authors.initials: G
authors.lastname: Hotta
authors.affiliation: Department of Infection Control and Prevention, Kyoto University Hospital, Kyoto, Japan; Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Infection Control and Prevention, Kyoto University Hospital, Kyoto, Japan; Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Matsumura
authors.affiliation: Department of Infection Control and Prevention, Kyoto University Hospital, Kyoto, Japan; Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Department of Infection Control and Prevention, Kyoto University Hospital, Kyoto, Japan; Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Takakura
authors.affiliation: Department of Infection Control and Prevention, Kyoto University Hospital, Kyoto, Japan; Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ichiyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058387:Candidemia / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology*; D055499:Catheter-Related Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011509:Proteoglycans; D012307:Risk Factors; D047071:beta-Glucans / Q000097:blood
chemical_list: D011509:Proteoglycans; D047071:beta-Glucans; C010770:polysaccharide-K
keywords: Candida; Catheter-related bloodstream infection; Risk factor