Author:
Dimitrios Farmakiotis, MD Jeffrey J. Tarrand, MD Dimitrios P. Kontoyiannis, MD, ScD, FIDSA
Full conference title:
IDWeek 2015 San Diego, CA
Date: 14 November 2017
Abstract:
Background. Central venous catheter (CVC) removal is beneficial in patients with CVC-related candidemia, defined as a higher colony count in a catheter lumen, compared to peripheral blood. However, clinicians are often faced with a blood culture growing Candida in a patient with a CVC, and few laboratories perform quantitative cultures. Therefore, it was proposed that short time-to-culture positivity (TTP) can be suggestive of catheter-related candidemia, in series of predominantly C. albicans candidemia episodes. Given the epidemiologic shift to non-albicans Candida species, and the longer time to detection for C. glabrata, compared to other Candida species, we studied the clinical characteristics of patients with CVC-related C. glabratafungemia and the diagnostic utility of time-to-reporting (TTR) of positive blood cultures.
Methods. We included patients with at least one blood culture(s) positive for C. glabrata, a CVC and available TTR, seen at MD Anderson Cancer Center between March 2005 and September 2013. CVC-related candidemia was defined as a colony count in a blood culture obtained via the CVC at least fivefold greater than the colony count in peripheral blood.
Results. Fifty-six of 119 patients studied (49%) were deemed to have CVC-related candidemia. Those patients were less likely to be on total parenteral nutrition (TPN, 34 [42%] versus 48 [59%] of those with non-CVC-related candidemia, P = 0.01), or have an absolute neutrophil count <100/μL (2 [4%] versus 13 [22%], P < 0.01). TTR was shorter in patients with CVC-related candidemia (mean ± standard deviation, 67 ± 35 hours) compared to those with non-CVC-related candidemia (79 ± 31 hours, P < 0.01), and had significant diagnostic value by ROC analysis (figure). A TTR <48 hours was 99% specific for CVC-related candidemia.
Conclusion. Among patients with C. glabrata fungemia, an abdominal source was more likely than CVC-related candidemia in severely neutropenic patients and in those receiving TPN. In the evaluation of patients with C. glabrata fungemia, a TTR of <48 hours could further support the decision to remove the CVC.
Disclosures. All authors: No reported disclosures.
Conference Year: 2015
Link to conference website: IDWeek 2015
Tables:
Link Conference abstract:
Conference abstracts, posters & presentations
-
Title
Author
Year
Number
Poster
-
v
S Ignatyeva1*, T Bogomolova1, Y Avdeenko1, S Khostelidi1, O Shadrivova1, Y Borzova1, I Zuzgin2, J Chudinovskikh2, M Motalkina2, M Popova3, O Uspenskaya4, N Klimko1, N Vasilyeva1
2022
33
-
v
L Petric1*, K Rosam1, T van Rens2, F Hagen2, M Lackner1
2022
32
-
v
MT Hedayati1*, M Ghazanfari1, A Arastehfar2, L Davoodi3, J Yazdani Charati4, M Hoenigl5, W Pan6
2022
31
-
v
M Chatti, S Ismail, H Chouaieb, M Ben Seif, R Mrassi, I Khammari, A Fathallah*
2022
30
-
v
Y Bahri1, S Ismail1, N Ben Sayed2, W Chambah2, M Chatti1, H Chouaieb1, N Sassi2, Y Ben Youssef2, B Sriha3, H Regaieg2, B Achour2, M Mokni3, A Khelif2, A Fathallah1*
2022
29
-
v
J Houst1,2*, A Skriba1, A Palyzova1, T Pluhacek1,2, M Petrik3, V Havlicek1,2
2022
28
-
v
ES Orefuwa1, R Penney1, DW Denning1,2*
2022
27
n/a
-
v
H Jaziri1*, I Khammari1,2, W Chenbah3, B Achour3, A Khelif3, A Fathallah1,2
2022
24