Members of the Barcelona Candidemia Project Study Group are listed in Table S1 (see Supplementary material).
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Impact of early central venous catheter removal on outcome in patients with candidaemia
Article first published online: 30 JUN 2007
DOI: 10.1111/j.1469-0691.2007.01758.x
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How to Cite
Rodriguez, D., Park, B. J., Almirante, B., Cuenca-Estrella, M., Planes, A. M., Mensa, J., Gimenez, M., Saballs, P., Fridkin, S. K., Rodriguez-Tudela, J. L., Pahissa, A. and Barcelona Candidemia Project Study Group (2007), Impact of early central venous catheter removal on outcome in patients with candidaemia. Clinical Microbiology and Infection, 13: 788–793. doi: 10.1111/j.1469-0691.2007.01758.x
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Members of the Barcelona Candidemia Project Study Group are listed in Table S1 (see Supplementary material).
Publication History
- Issue published online: 30 JUN 2007
- Article first published online: 30 JUN 2007
- Original Submission: 21 November 2006; Revised Submission: 28 March 2007; Accepted: 28 March 2007
Keywords:
- Candidaemia;
- central venous catheter;
- early removal;
- mortality;
- outcome;
- risk-factors
Abstract
Removal of central venous catheters (CVCs) from candidaemic patients is considered the reference standard of care, although this practice is not always possible. The impact of prompt catheter removal on outcome was investigated by analysing data from an active population-based surveillance study in Barcelona, Spain. Patients with candidaemia and a CVC were identified between January 2002 and December 2003. Cases with CVC removal within 2 days were classified as having early CVC removal. Outcome, defined as in-hospital mortality 2–30 days after diagnosis of candidaemia, was determined among hospitalised adults using univariate, Kaplan–Meier and multivariate logistic regression analysis. Outpatients, paediatric patients and those who died or were discharged within 2 days were excluded. The study identified 265 patients with candidaemia and a CVC. Median time from diagnosis of candidaemia to catheter removal was 1 day (range 0–29 days). Overall, 172 patients met the criteria for inclusion in the outcome study. Patients with early CVC removal differed significantly from those with delayed CVC removal. According to univariate, Kaplan–Meier and multivariate analysis, the marker most predictive of in-hospital mortality among candidaemic patients with CVCs was severity of illness. These data suggest that timing of CVC removal may best be determined after carefully considering the risks and benefits to individual patients.