Epidemiology of Blood Stream Infection Due to Candida Species in a Tertiary Care Hospital in Japan over 12 Years: Importance of Peripheral Line-Associated Candidemia

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2016 Nov 1

PMID 27798663

Citations 11

Authors

Masahiro Ishikane

Kayoko Hayakawa

Satoshi Kutsuna

Nozomi Takeshita

Norio Ohmagari

Affiliations

Soon will be listed here.

Abstract

Background: Candidemia is an important cause of mortality in healthcare settings. Peripheral lines are a source of candidemia, yet few studies have reported on the clinico-epidemiological features of candidemia due to peripheral-line associated blood stream infection (PLABSI).

Methods: We conducted a single-centre retrospective cohort study of all patients with candidemia between 2002 and 2013. PLABSI was defined as the presence of at least one of the following: the presence of phlebitis or the resolution of clinical symptoms after peripheral-line withdrawal, with careful exclusion of an alternative explanation for bacteraemia. We described the epidemiology of candidemia and assessed predictive factors of PLABSI due to Candida spp., peripheral line-associated candidemia (PLAC), compared with non-PLAC.

Results: A total of 301 episodes of candidemia, including 37 of PLAC, were diagnosed during the study period. Central-line associated blood stream infection, intra-abdominal infection, and infection of unknown source accounted for the remaining 233, 14, and 17 cases, respectively. The overall incidence rate of candidemia was 0.11/1000 patient-days. In multivariate analysis, cephalosporin exposure (odds ratio [OR] = 2.22, 95% CI 1.04-4.77), polymicrobial bacteraemia/fungaemia (OR = 2.87, 95% CI 1.02-8.10), and ID specialist consultation (OR = 2.40, 95% CI 1.13-5.13) were identified as independent predictors of PLAC. Although non-PLAC had a higher mortality, the length of hospital stay after candidemia was similar between the two groups and candidemia duration was longer in the PLAC group.

Conclusion: PLACs are an important cause of candidemia in hospitalized patients. Appropriate identification and management of PLAC are crucial.

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References

Oud L . Secular Trends in Utilization of Critical Care Services Among Candidemia-Associated Hospitalizations: A Population-Based Cohort Study. J Clin Med Res. 2015; 8(1):40-3. PMC: 4676344. DOI: 10.14740/jocmr2387w. View

Yapar N . Epidemiology and risk factors for invasive candidiasis. Ther Clin Risk Manag. 2014; 10:95-105. PMC: 3928396. DOI: 10.2147/TCRM.S40160. View

OGrady N, Alexander M, Dellinger E, Gerberding J, Heard S, Maki D . Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. MMWR Recomm Rep. 2002; 51(RR-10):1-29. View

Solomkin J, Mazuski J, Bradley J, Rodvold K, Goldstein E, Baron E . Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis. 2009; 50(2):133-64. DOI: 10.1086/649554. View

Cornely O, Bassetti M, Calandra T, Garbino J, Kullberg B, Lortholary O . ESCMID* guideline for the diagnosis and management of Candida diseases 2012: non-neutropenic adult patients. Clin Microbiol Infect. 2012; 18 Suppl 7:19-37. DOI: 10.1111/1469-0691.12039. View

Hassan I, Powell G, Sidhu M, Hart W, Denning D . Excess mortality, length of stay and cost attributable to candidaemia. J Infect. 2009; 59(5):360-5. DOI: 10.1016/j.jinf.2009.08.020. View

Hirai Y, Asahata S, Ainoda Y, Goto A, Fujita T, Totsuka K . Nosocomial Candida parapsilosis candidaemia: risk factors, antifungal susceptibility and outcome. J Hosp Infect. 2014; 87(1):54-8. DOI: 10.1016/j.jhin.2014.02.006. View

Ding X, Yan D, Sun W, Zeng Z, Su R, Su J . Epidemiology and risk factors for nosocomial Non-Candida albicans candidemia in adult patients at a tertiary care hospital in North China. Med Mycol. 2015; 53(7):684-90. DOI: 10.1093/mmy/myv060. View

Lionakis M, Netea M . Candida and host determinants of susceptibility to invasive candidiasis. PLoS Pathog. 2013; 9(1):e1003079. PMC: 3536687. DOI: 10.1371/journal.ppat.1003079. View

10.

Pujol M, Hornero A, Saballs M, Argerich M, Verdaguer R, Cisnal M . Clinical epidemiology and outcomes of peripheral venous catheter-related bloodstream infections at a university-affiliated hospital. J Hosp Infect. 2007; 67(1):22-9. DOI: 10.1016/j.jhin.2007.06.017. View

11.

Giri S, Kindo A . A review of Candida species causing blood stream infection. Indian J Med Microbiol. 2012; 30(3):270-8. DOI: 10.4103/0255-0857.99484. View

12.

Nagao M . A multicentre analysis of epidemiology of the nosocomial bloodstream infections in Japanese university hospitals. Clin Microbiol Infect. 2012; 19(9):852-8. DOI: 10.1111/1469-0691.12083. View

13.

Fernandez-Ruiz M, Aguado J, Almirante B, Lora-Pablos D, Padilla B, Puig-Asensio M . Initial use of echinocandins does not negatively influence outcome in Candida parapsilosis bloodstream infection: a propensity score analysis. Clin Infect Dis. 2014; 58(10):1413-21. DOI: 10.1093/cid/ciu158. View

14.

Mermel L, Allon M, Bouza E, Craven D, Flynn P, OGrady N . Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2009; 49(1):1-45. PMC: 4039170. DOI: 10.1086/599376. View

15.

Barchiesi F, Orsetti E, Gesuita R, Skrami E, Manso E . Epidemiology, clinical characteristics, and outcome of candidemia in a tertiary referral center in Italy from 2010 to 2014. Infection. 2015; 44(2):205-13. DOI: 10.1007/s15010-015-0845-z. View

16.

Pappas P, Kauffman C, Andes D, Clancy C, Marr K, Ostrosky-Zeichner L . Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2015; 62(4):e1-50. PMC: 4725385. DOI: 10.1093/cid/civ933. View

17.

Poikonen E, Lyytikainen O, Anttila V, Koivula I, Lumio J, Kotilainen P . Secular trend in candidemia and the use of fluconazole in Finland, 2004-2007. BMC Infect Dis. 2010; 10:312. PMC: 2988049. DOI: 10.1186/1471-2334-10-312. View

18.

Kontoyiannis D, Vaziri I, Hanna H, Boktour M, Thornby J, Hachem R . Risk Factors for Candida tropicalis fungemia in patients with cancer. Clin Infect Dis. 2001; 33(10):1676-81. DOI: 10.1086/323812. View

19.

Peman J, Canton E, Quindos G, Eraso E, Alcoba J, Guinea J . Epidemiology, species distribution and in vitro antifungal susceptibility of fungaemia in a Spanish multicentre prospective survey. J Antimicrob Chemother. 2012; 67(5):1181-7. DOI: 10.1093/jac/dks019. View

20.

Zaoutis T, Argon J, Chu J, Berlin J, Walsh T, Feudtner C . The epidemiology and attributable outcomes of candidemia in adults and children hospitalized in the United States: a propensity analysis. Clin Infect Dis. 2005; 41(9):1232-9. DOI: 10.1086/496922. View