A Single Center's Experience withCandida parapsilosisRelated Long-Term Central Venous Access Device Infections: The Port Removal Decision and Its Outcomes
| Autor: | İlker Devrim, Ozgur Carti, Bengü Demirağ, Tülin Erdem, Yöntem Yaman, Nuri Bayram, Şener Tulumoğlu, Yeşim Oymak, Gulcihan Ozek, Gülfidan Gamze, Canan Vergin, Salih Gözmen, Burcak Tatli Gunes |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Antifungal Agents Neutropenia Adolescent Fever Decision Making Candida parapsilosis Single Center Port (medical) Neoplasms medicine Central Venous Catheters Humans Child Intensive care medicine biology business.industry Candidiasis Infant Blood Proteins Hematology medicine.disease biology.organism_classification Pediatric cancer Venous access Increased risk Oncology Child Preschool Pediatrics Perinatology and Child Health Female business Fungemia |
| Zdroj: | Pediatric Hematology and Oncology. 31:435-441 |
| ISSN: | 1521-0669 0888-0018 |
| DOI: | 10.3109/08880018.2013.862587 |
| Popis: | Pediatric cancer patients have an increased risk of potentially life-threatening fungal infections such as Candida parapsilosis, associated with long-term CVADs. The Infectious Diseases Society of America (IDSA) guidelines on Candida catheter-related bloodstream infections recommend systemic antifungal therapy and catheter removal. In this study, we focused on our experience with antifungal failure due to totally implanted catheter-associated C. parapsilosis bloodstream infections. We investigated cases leading to port removal in pediatric malignancy patients and the associated patient outcomes. In the first phase of the study, a retrospective chart review was performed to collect patient information, including primary disease; time from hospitalization to port-related candidemia; antifungal drug choice; and the time at which port removal occurred. During the second phase, antifungal susceptibility tests for C. parapsilosis were performed in our microbiology laboratory. All patients had fevers and were neutropenic at the time of candidemia diagnosis. The mean duration between the first isolation of Candida parapsilosis from the port samples to the port removal was 9.75 ± 5.29 days for 11 patients. Patient fevers lasted for a mean time of 16.22 ± 6.51 days. The median recovery duration from fever after CVC removal was four days (range 2-12 days). The median duration for achieving negative blood cultures, following antifungal treatment was 18 days (range 10-27 days). Our data favored the removal of catheters in the presence of ongoing fever, as suggested by the guidelines, independent of the chosen antifungal treatment. Future studies with large samples are needed to evaluate the effects of catheter removal on mortality rates and patient outcomes. |
| Databáze: | OpenAIRE |
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