Time of catheter removal in candidemia and mortality

Nucci, Márcio; Braga, Paula Rocha; Nouér, Simone Aranha; Anaissie, Elias

doi:10.1016/j.bjid.2018.10.278

Cited by 21 publications

(14 citation statements)

References 30 publications

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“…Candida albicans are fungal pathogens often associated with cases of mortality from systemic infection [ 27 , 28 ]. Biofilm formation, one of the virulence factors, stands out for its appearance on different surfaces [ 29 ] and for its greater infectious capacity [ 30 ] Biofilm infections of C. albicans can result in increased length of hospital stay, increased cost of antifungal therapy and risk of death [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Cold Atmospheric Plasma Jet Associated to Polyene Antifungals on Candida albicans Biofilms

et al. 2021

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The increasing incidence of antifungal resistance represents a great challenge in the medical area and, for this reason, new therapeutic alternatives for the treatment of fungal infections are urgently required. Cold atmospheric plasma (CAP) has been proposed as a promising alternative technique for the treatment of superficial candidiasis, with inhibitory effect both in vitro and in vivo. However, little is known on the association of CAP with conventional antifungals. The aim of this study was to evaluate the effects of the association between CAP and conventional polyene antifungals on Candida albicans biofilms. C. albicans SC 5314 and a clinical isolate were used to grow 24 or 48 h biofilms, under standardized conditions. After that, the biofilms were exposed to nystatin, amphotericin B and CAP, separately or in combination. Different concentrations of the antifungals and sequences of treatment were evaluated to establish the most effective protocol. Biofilms viability after the treatments was compared to negative control. Data were compared by One-way ANOVA and post hoc Tukey (5%). The results demonstrate that 5 min exposure to CAP showed more effective antifungal effect on biofilms when compared to nystatin and amphotericin B. Additionally, it was detected that CAP showed similar (but smaller in magnitude) effects when applied in association with nystatin and amphotericin B at 40 µg/mL and 60 µg/mL. Therefore, it can be concluded that the application of CAP alone was more effective against C. albicans biofilms than in combination with conventional polyene antifungal agents.

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Section: Discussionmentioning

confidence: 99%

Effect of Cold Atmospheric Plasma Jet Associated to Polyene Antifungals on Candida albicans Biofilms

et al. 2021

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“…In turn, in single-center Swedish studies, C. albicans constituted as much as 65.0% of isolated Candida fungi [29]. However, the participation of individual species may vary depending on the patient group and institution [5,9,30,31].…”

Section: Discussionmentioning

confidence: 99%

“…This increases the risk of candidemia from the surgical site. Also, long-term central venous catheters used in cancer patients, a stay in an intensive care unit, and vancomycin or piperacillin/tazobactam treatment also promote fungal infections [3,8,9].…”

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confidence: 99%

Etiology of candidemia in patients with solid tumors - 7 years of experience of one oncology center

Szymankiewicz¹,

Nowikiewicz²

2021

neo

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Although the candidemia still remains a serious health problem, the study of candidemia in cancer patients is limited. We conducted a retrospective analysis of candidemia among 31 adult patients hospitalized in one oncological center. The mean annual incidence of candidemia was 0.14 ± 0.05 / 1000 patient-days (range 0.04-0.91). In 10 patients (32.3%), the catheter-related infection was diagnosed; in the remaining 21 patients (67.7%), it was a secondary infection. From 31 patients of candidemia, 15 died (48.4% 30-day mortality), but an overall mortality rate during hospital stay was 61.3% (19 cases). Patients with secondary candidemia, ASA = IV and complicated postoperative course, had poorer 1-year survival probability compared with patients with catheter-related infection (p = 0.004), ASA < IV (p = 0.0393) and uncomplicated postoperative course (p = 0.0009). C. glabrata (n = 13, 41.9%) was the most frequently isolated species, followed by C. albicans (n = 12, 38.7%) and C. parapsilosis (n= 3, 9.7%). C. lusitaniae (n = 2, 6.5%), and C. tropicalis (n = 1, 3.2%) were sporadically isolated. Within C. glabrata, there was no resistance to anidulafungin, two strains (15.4%) were resistant to fluconazole, while the othe rs showed intermediate susceptibilities to this drug. A total of 58.0% of all Candida spp. strains were sensitive to fluconazole, and 90.0% of the strains were sensitive to anidulafungin. Mortality in candidemia among patients with solid tumors undergoing surgery remains high. The complicated postoperative course requiring reoperation and secondary origin of candidemia are factors for poor prognosis. The demonstrated dominant role of C. glabrata in inducing candidemia is becoming a serious clinical and therapeutic problem. Key words: candidemia; solid tumors; mortality; etiologic agents; sensitivity to antimycotics The increasing incidence of candidemia among cancer patients and poor prognosis encourages the undertaking of research on the current etiological agents of candidemia. While there are quite numerous reports of candidemia among patients with hematological cancers, there are few publications dealing with this problem among patients with solid tumors [1-3].

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“…The recommendation of removing CVC in patients with candidaemia is uniformly supported by various guidelines despite the lack of randomised controlled trials to support this intervention 57 . The rationale for this advice is that the CVC is assumed to be the source of infection 58 . CVC retention is associated with increased duration of candidaemia, persistent candidaemia, and increase in metastatic complications and so early removal of CVC is generally recommended as it is associated with improved survival 59,60 .…”

Section: Quality Indicatorsmentioning

confidence: 99%

European confederation of medical mycology quality of clinical candidaemia management score: A review of the points based best practice recommendations

Bal

2020

Mycoses

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Candidaemia is associated with high mortality. In the last few years, several guidelines have been published on the management of Candida bloodstream infection. However, adherence to the practice guidelines has been suboptimal. In order to facilitate and objectively measure the adherence to good practice recommendations, a scoring criterion was published by the European Confederation of Medical Mycology (ECMM). The ECMM Quality (EQUAL) of Clinical Candidaemia Management is an audit tool that comprises of 10 quality indicators. Each quality indicator is allotted between 1 and 3 points. The maximum achievable score is 22 or 19 in patients with or without a central venous catheter, respectively. This paper reviews each of the 10 quality indicators and provides the context for improving quality within the individual domains. The review also suggests areas that are in need of further clarity or areas which merit attention in the future updates of the EQUAL scoring system so that clinicians are able to derive maximum benefit from the audit tool. The EQUAL scoring tool is an important milestone in the quality improvement aspect of the management of candidaemia and contributes to the various components of clinical governance in the management of Candida infection of the bloodstream.

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Time of catheter removal in candidemia and mortality

Cited by 21 publications

References 30 publications

Effect of Cold Atmospheric Plasma Jet Associated to Polyene Antifungals on Candida albicans Biofilms

Effect of Cold Atmospheric Plasma Jet Associated to Polyene Antifungals on Candida albicans Biofilms

Etiology of candidemia in patients with solid tumors - 7 years of experience of one oncology center

European confederation of medical mycology quality of clinical candidaemia management score: A review of the points based best practice recommendations

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