Comparison of mortality between Candida CRBSI and Bacterial CRBSI
| Candida CRBSI (n = 33) | Bacterial CRBSI (n = 264) | χ2 | P | |
|---|---|---|---|---|
| Number of deaths (rates, %) | 17 (51.52) | 57 (21.60) | 14.041 | 0.001 |
Overall survival of patients with Candida CRBSI
| Group | Number of survival (rates, %) | Number of deaths (rates, %) | Survivor (n = 16) | |
|---|---|---|---|---|
| Fever reduction time (d) | Time for blood culture to turn negative (d) | |||
| Timely catheter removal + appropriate antifungal treatment (n = 9) | 8 (88.89) | 1 (11.11) | 5.50 ± 2.27 | 4.38 ± 1.60 |
| Timely catheter removal + inappropriate antifungal treatment (n = 7) | 3 (42.86) | 4 (57.14) | 11.33 ± 1.53* | 10.33 ± 2.52# |
| Delayed catheter removal + appropriate antifungal treatment (n = 11) | 5 (45.45) | 6 (54.55) | 9.60 ± 2.41* | 8.80 ± 2.28# |
| Delayed catheter removal + inappropriate antifungal treatment (n = 6) | 0 | 6 (100.00) | ||
| Total numbers (n = 33) | 16 (48.48) | 17 (51.52) | 7.88 ± 3.26 | 6.88 ± 3.22 |
Univariate analysis
| Risk factor | Candida infection (n = 33) | Bacterial infection (n = 264) | P |
|---|---|---|---|
| Mechanical ventilation (n, %) | 12 (36.4%) | 104 (39.4%) | 0.737 |
| Hospital stay >15 d (n, %) | 28 (84.8%) | 204 (77.3%) | 0.321 |
| Broad-spectrum antibiotics (n, %) | 31 (93.9%) | 232 (87.9%) | 0.396* |
| Parenteral nutrition (n, %) | 30 (90.9%) | 104 (39.4%) | < 0.001 |
| Age >65 years (n, %) | 28 (84.8%) | 208 (78.8%) | 0.416 |
| Diabetes or hyperglycemia (n, %) | 18 (54.5%) | 113 (42.8%) | 0.200 |
| >4 underlying diseases (n, %) | 28 (84.8%) | 195 (73.9%) | 0.169 |
| Catheter indwelling ≥14 d (n, %) | 31 (93.9%) | 185 (70.1%) | 0.004 |
| Renal inadequacy (n, %) | 15 (45.5%) | 127 (48.1%) | 0.774 |
| MODS (n, %) | 14 (42.4%) | 58 (22.0%) | 0.010 |
| Glucocorticoids (>400 mg hydrocortisone/d; n, %) | 28 (84.8%) | 74 (28.0%) | < 0.001 |
| Immunosuppressant/chemoradiotherapy (n, %) | 12 (36.4%) | 37 (14.0%) | 0.001 |
| Granulocytopenia (n, %) | 8 (24.2%) | 16 (6.1%) | 0.002* |
| Major surgery (n, %) | 3 (9.1%) | 16 (6.1%) | 0.454* |
| Urinary catheterization (n, %) | 19 (57.6%) | 125 (47.3%) | 0.268 |
| Blood or albumin transfusion (n, %) | 32 (97.0%) | 228 (86.4%) | 0.096* |
Multivariate analysis
| Risk factor | OR | 95% CI | P |
|---|---|---|---|
| Parenteral nutrition | 5.400 | 0.472–61.752 | 0.0175 |
| Time of catheter indwelling ≥14 d | 0.488 | 0.043–5.486 | 0.561 |
| Immunosuppressant/chemoradiotherapy | 0.800 | 0.188–3.401 | 0.763 |
| MODS | 0.346 | 0.100–1.198 | 0.094 |
| Glucocorticoids | 10.313 | 2.032–52.330 | 0.005 |
| Granulocytopenia | 2.625 | 0.670–10.280 | 0.166 |
Baseline characteristics of patients with Candida CRBSI and non-Candida CRBSI
| Characteristics | Candida CRBSI (n = 33) | Bacterial CRSBI (n = 264) | χ2/t | P | |
|---|---|---|---|---|---|
| Sex (male), n (%) | 20 (60.6%) | 177 (67.0%) | 0.545 | 0.461 | |
| Age, mean (year) | 67.79 ± 21.05 | 69.86 ± 18.07 | 0.544 | ||
| Underlying diseases, n (%) | |||||
| Cerebrovascular accidents | 12 (36.4%) | 131 (49.6%) | 2.065 | 0.151 | |
| Malignant tumors | 5 (15.2%) | 79 (29.9%) | 3.156 | 0.076 | |
| Acute leukemia | 7 (22.2%) | 91 (34.5%) | 2.332 | 0.127 | |
| Chronic obstructive pulmonary disease | 3 (9.09%) | 57 (21.6%) | 2.121 | 2.121 | |
| Chronic kidney disease | 8 (24.2%) | 89 (33.3%) | 1.912 | 0.167 | |
| Infectious shock | 13 (39.4%) | 135 (51.1%) | 1.618 | 0.203 | |
| Severe trauma | 3 (9.1%) | 59 (22.3%) | 3.121 | 0.077 | |
| Severe pancreatitis | 3 (9.1%) | 53 (20.1%) | 2.567 | 0.109 | |
| Diabetes | 13 (39.4%) | 143 (54.2%) | 2.567 | 0.109 | |
| Catheter type, n (%) | |||||
| Single-lumen CVC catheter | 14 (42.4%) | 155 (58.7%) | 3.173 | 0.075 | |
| Double-lumen CVC catheter | 11 (33.3%) | 59 (22.3%) | 0.151 | 0.698 | |
| Single-lumen PICC catheter | 8 (24.2%) | 99 (37.5%) | 2.237 | 0.135 | |
| Catheter retention site n (%) | |||||
| CVC | 25 (75.8%) | 175 (66.3%) | 1.196 | 0.274 | |
| Subclavian vein | 8 (32.0%) | 29 (16.6%) | 3.454 | 0.063 | |
| Internal jugular vein | 11 (44.0%) | 99 (56.6%) | 01.397 | 0.237 | |
| Femoral vein | 6 (24.0%) | 57 (32.6%) | 0.745 | 0.388 | |
| PICC | 8 (24.2%) | 89 (32.1%) | 1.054 | 0.305 | |
| Cubital vein | 5 (62.5%) | 67 (75.35%) | 0.627 | 0.429 | |
| Median cubital vein | 3 (37.5%) | 22 (24.7%) | 0.627 | 0.429 | |