TABLE 1.
Demographic and clinical characteristics of the patients with mixed Candida/bacterial bloodstream infections (cases) compared with the patients with monomicrobial candidaemia (controls)
| Characteristics | Cases (n = 37) | Controls (n = 89) | p |
|---|---|---|---|
| Age, median years (IQR) | 63 (57–73) | 68 (57–74) | 0.15 |
| Male sex | 19 (51) | 54 (61) | 0.43 |
| Co-morbidities | |||
| Diabetes mellitus | 10 (27) | 24 (27) | 1.00 |
| Chronic kidney disease | 6 (16) | 10 (11) | 0.56 |
| Chronic liver disease | 3 (8) | 7 (8) | 1.00 |
| Solid tumour | 17 (46) | 43 (48) | 0.85 |
| Haematological disease | 7 (19) | 13 (15) | 0.60 |
| Charlson co-morbidity index, median (IQR) | 2 (2–5.5) | 2 (1–6) | 0.78 |
| Prior hospital stay, median days (IQR) | 25 (11–60) | 23 (11–38) | 0.10 |
| Risk factors for Candida infectiona | |||
| ICU residence | 19 (51) | 32 (36) | 0.12 |
| Candida colonization | 7 (19) | 13 (15) | 0.60 |
| Neutropenia | 5 (14) | 14 (16) | 0.79 |
| Chemotherapy | 11 (30) | 24 (27) | 0.83 |
| Corticosteroidb | 12 (32) | 15 (17) | 0.06 |
| Surgery | 9 (24) | 20 (23) | 1.00 |
| Hyperalimentation | 29 (78) | 79 (89) | 0.16 |
| Central venous catheter | 30 (81) | 65 (73) | 0.38 |
| Urinary catheter | 26 (70) | 56 (63) | 0.54 |
| Prior use of antibiotics | 33 (89) | 83 (93) | 0.48 |
| Prior azole exposure | 5 (14) | 11 (12) | 1.00 |
| Severity of illness | |||
| SOFA score, median (IQR) | 7 (3–10) | 6 (2.5–9) | 0.13 |
| Pitt bacteraemia score, median (IQR) | 4 (2–7.5) | 3 (1–6) | 0.14 |
| Source of candidaemia | |||
| Catheter | 10 (27) | 26 (29) | 0.49 |
| Gastrointestinal tract | 13 (35) | 41 (46) | |
| Othersc | 3 (8) | 4 (5) | |
| Unknown | 11 (30) | 18 (20) | |
| First-line antifungal agent | |||
| Fluconazole | 18 (49) | 45 (51) | 0.63 |
| Amphotericin B | 9 (24) | 15 (17) | |
| Othersd | 2 (5) | 3 (3) | |
| None | 8 (22) | 26 (29) | |
| Delay in initiation of antifungal therapy, median days (IQR)e | 3 (1–4) | 2 (1–3) | 0.53 |
| Total antifungal therapy, median days (IQR) | 22 (7–27) | 14 (7–21) | 0.80 |
Data are no. (%) of patients, unless otherwise indicated.
ICU, intensive care unit; IQR, interquartile range; SOFA, sequential organ failure assessment.
a
Risk factors within 30 days before candidaemia.
b
A mean minimum dose of 10 mg/day of prednisone equivalent for >14 days.
c
Genitourinary tract (n = 6) and deep soft tissue (n = 1).
d
Itraconazole (n = 4) and caspofungin (n = 1).
e
The time between drawing the first blood samples culture-positive for Candida species and initiation of antifungal therapy.