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Volume 44, Number 6, December 2011


Chen-Chi Tsai, Chorng-Jang Lay, Chun-Lung Wang, Mei-Lin Lin, Su-Pen Yang


Received: July 16, 2009    Revised: March 10, 2010    Accepted: June 1, 2010   

 

Corresponding author:

 

  • Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
  • Department of Medicine, National Yang-Ming University, Taipei, Taiwan
  • Corresponding Author InformationCorresponding author. Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei, Taiwan.


 

Background and purpose: 

 Immediate removal of central venous catheters (CVCs) is not possible in patients with candidemia requiring total parenteral nutrition (TPN). This study analyzed the possible prognostic factors for survival time after onset of candidemia among nonneutropenic adults requiring TPN.



 

Methods:

 We conducted a retrospective analysis from September 2003 to August 2005.



 

Results:

 A total of 59 nonneutropenic adults with candidemia and requiring TPN were identified retrospectively. All Candida isolates were susceptible to flucytosine and amphotericin B. With the exception of one C glabrata isolate, all other isolates were susceptible to fluconazole and itraconazole. The only predictor of 30-day survival rate after onset of candidemia identified in our analysis was an Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 23 points or less. Adults with higher APACHE II scores, who did not have their CVCs changed, did not receive antifungal treatment, or who had thrombocytopenia had shorter survival times after the onset of candidemia.



 

Conclusion:

 APACHE II scores, thrombocytopenia, antifungal agents, and CVCs changes are associated with survival time in nonneutropenic adults requiring TPN after the onset of candidemia.



 

Key words:

 Antifungal agentCandidemiaCentral venous catheterTotal parenteral nutrition