Table 3. Univariate analysis of risk factors for ocular candidiasis.
| Variable | No eye involvement (n = 155) | Eye involvement (n = 13) | p |
|---|---|---|---|
| Age, years, (mean ± SD) | 64.6 ± 14.7 | 54.5 ± 16.4 | 0.02 |
| Sex, male (%) | 84 (54.2) | 10 (76.9) | 0.14 |
| Hospitalization | |||
| Medical ward | 58 (37.4) | 2 (15.4) | 0.13 |
| ICU setting | 43 (27.7) | 5 (38.5) | 0.52 |
| Surgical ward | 42 (27.1) | 5 (38.5) | 0.35 |
| Emergency department | 8 (9.5) | 1 (2.5) | 0.57 |
| Others | 4 (2.6) | 0 (0) | 1 |
| Type of infection | |||
| Nosocomial | 141 (91.0) | 11 (84.6) | 0.35 |
| Community-acquired | 13 (8.4) | 2 (15.4) | 0.32 |
| Health-care–associated | 1 (0.6) | 0 (0) | 1 |
| Time between hospitalization and onset of candidemia | 22.0 (13–35) | 21.5 (14–34) | 0.65 |
| Hospitalization within previous 3 months | 100 (64.5) | 8 (61.5) | 1 |
| Underlying conditions | |||
| Cancer | 67 (43.2) | 9 (69.2) | 0.08 |
| Solid tumor | 56 (36.1) | 8 (61.5) | 0.08 |
| Cardiovascular disease | 53 (34.2) | 5 (38.5) | 0.76 |
| Renal failure | 41 (26.5) | 7 (53.8) | 0.05 |
| Diabetes mellitus | 39 (25.2) | 3 (23.1) | 1 |
| Neurologic disease | 35 (22.6) | 3 (23.1) | 1 |
| Surgery (all types <30 days) | 24 (15.5) | 4 (30.8) | 0.23 |
| Liver disease | 22 (14.2) | 1 (7.7) | 1 |
| Transplant recipients | 15 (9.7) | 1 (7.7) | 1 |
| Neutropenia | 12 (7.7) | 2 (15.4) | 0.29 |
| Leukemia | 9 (5.8) | 1 (7.7) | 0.56 |
| Mucositis | 8 (5.2) | 2 (15.4) | 0.17 |
| Autoimmune disease | 7 (4.5) | 1 (7.7) | 0.48 |
| Lymphoma | 2 (1.3) | 0 (0) | 1 |
| HIV/AIDS | 2 (1.3) | 0 (0) | 1 |
| Pitt score | 1 (0–2) | 3 (0.5–4) | 0.01 |
| Risk factors | |||
| Antibiotic therapy within previous 30 days | 147 (94.8) | 12 (92.3) | 0.52 |
| Immunosuppressive therapy | 52 (33.5) | 6 (46.2) | 0.37 |
| Antifungal therapy within previous 30 days | 43 (27.7) | 1 (7.7) | 0.18 |
| Corticosteroids at the time of candidemia | 31 (20.0) | 4 (30.4) | 0.47 |
| Clinical picture | |||
| Sepsis | 126 (81.3) | 9 (69.2) | 0.28 |
| Severe sepsis | 16 (10.3) | 3 (23.1) | 0.17 |
| Septic shock | 13 (8.4) | 1 (7.7) | 0.52 |
| Origin | |||
| Catheter | 83 (53.5) | 5 (38.5) | 0.39 |
| Primary | 72 (46.5) | 8 (61.5) | 0.39 |
| Urinary tract | 13 (8.4) | 0 (0) | 0.6 |
| Intra-abdominal | 5 (3.2) | 0 (0) | 1 |
| Candida species | |||
| C.albicans | 73 (47.1) | 10 (76.9) | 0.04 |
| C. parapsilosis | 34 (21.9) | 2 (15.4) | 0.73 |
| C. glabrata | 20 (12.9) | 0 (0) | 0.36 |
| C. tropicalis | 17 (11.0) | 0 (0) | 0.36 |
| C. krusei | 4 (2.6) | 0 (0) | 1 |
| Others | 28 (18.1) | 1 (7.7) | 0.47 |
| Intravascular catheter at the time of candidemia | |||
| Overall | 151 (97.4) | 13 (100) | 1 |
| Central | 122 (78.7) | 12 (92.3) | 0.47 |
| Peripheral | 73 (47.1) | 4 (30.8) | 0.39 |
| Type of catheter | |||
| Subclavian | 40 (25.8) | 5 (38.5) | 0.33 |
| Jugular | 35 (22.6) | 5 (38.5) | 0.19 |
| Peripherally inserted central catheter | 29 (18.7) | 1 (7.7) | 0.47 |
| Arterial | 20 (12.9) | 3 (23.1) | 0.39 |
| Tunneled central venous catheter | 18 (11.6) | 1 (7.7) | 1 |
| Femoral | 17 (11.0) | 2 (15.4) | 0.64 |
| Catheter removal | 135 (87.1) | 11 (84.6) | 0.68 |
| TPN during candidemia | 78 (50.3) | 7 (53.8) | 1 |
| Complications due to candidemia | |||
| Other organs involvement | 15 (9.7) | 5 (38.5) | 0.01 |
| ICU admission | 9 (5.8) | 1 (7.7) | 0.56 |
| Dialysis | 3 (1.9) | 4 (30.8) | 0.001 |
| Concomitant bacterial infection | 19 (12.3) | 1 (7.7) | 1 |
| Initiation of antifungal therapy | |||
| < 24 h since positive BC | 59 (38.1) | 6 (46.2) | 0.56 |
| < 48 h since positive BC | 105 (67.7) | 13 (100) | 0.01 |
| < 72 h since positive BC | 125 (80.6) | 13 (100) | 0.12 |
| Time to initiation of antifungal therapy since positive BC, median, days (IQR) | 2 (1–3) | 2 (1–2) | 0.43 |
| First antifungal therapy | |||
| Azoles | 88 (56.5) | 10 (76.9) | 0.24 |
| Echinocandins | 53 (34.2) | 3 (23.1) | 0.54 |
| L-AMB | 14 (9.0) | 0 (0) | 0.60 |
| Length of antifungal therapy | 22.2 ± 14.5 | 39.6± 36.6 | 0.047 |
| Persistent candidemia | 41 (26.5) | 8 (61.5) | 0.02 |
| Length of antifungal treatment (median, days) | 3 (1–15) | 2 (1–16) | 0.94 |
| Death | |||
| 7-day mortality | 6 (3.9) | 0 (0) | 1 |
| Overall mortality | 28 (18.1) | 5 (38.5) | 0.13 |
BC blood culture; ICU intensive care unit; IQR interquartile range; L-AMB liposomal amphotericin B; TPN total parenteral nutrition.