Table 2.
The source of candidemia, prior antibiotic and antifungal therapy of the mono-CA-BSI compared with the Mixed-CA/B-BSIs
| Variable | Total(n = 117) | Mono-CA-BSI(n = 93) | Mixed-CA/B-BSIs(n = 24) | P value |
|---|---|---|---|---|
| Source of candidaemia [n (%)] | ||||
| Definitive CVC-related | 34 (29.1%) | 27 (29.0%) | 7 (29.2%) | 0.990 |
| Intra-abdominal | 24 (20.5%) | 18 (19.4%) | 6 (25.0%) | 0.744 |
| Primary | 22 (18.8%) | 15 (16.1%) | 7 (29.2%) | 0.244 |
| Lower respiratory tract | 12 (10.3%) | 11 (11.8%) | 1 (4.2%) | 0.468 |
| Urinary tract infection | 7 (6.0%) | 6 (6.5%) | 1 (4.2%) | > 0.999 |
| Gastrointestinal tract | 6 (5.1%) | 6 (6.5%) | 0 (0.0%) | 0.344 |
| Skin and Soft tissue | 5 (4.3%) | 4 (4.3%) | 1 (4.2%) | > 0.999 |
| Meningitis | 3 (2.6%) | 2 (2.2%) | 1 (4.2%) | 0.501 |
| Endocardium | 2 (1.7%) | 2 (2.2%) | 0 (0.0%) | > 0.999 |
| Osteoarthritis | 1 (0.9%) | 1 (1.1%) | 0 (0.0%) | > 0.999 |
| Source control [n (%)] | ||||
| Removal of contaminated lines a | 40 (34.2%) | 27 (29.0%) | 13 (54.2%) | 0.021 |
| Draining of fungal collection | 19 (16.2%) | 14 (15.1%) | 5 (20.8%) | 0.708 |
| Days of prior antibiotic exposure (IQR) | 11.0 (3.0,22.0) | 8.0 (1.0,20.5) | 17.0 (10.3,28.8) | 0.007 |
| Prior antibiotic exposure b [n (%)] | 93 (79.5%) | 69 (74.2%) | 24 (100.0%) | 0.012 |
| Cephalosporins | 33 (28.2%) | 25 (26.9%) | 8 (33.3%) | 0.531 |
| Carbapenems | 49 (41.9%) | 41 (44.1%) | 8 (33.3%) | 0.341 |
| Penicillins | 25 (21.4%) | 19 (20.4%) | 6 (25.0%) | 0.626 |
| Quinolones | 4 (3.4%) | 4 (4.3%) | 0 (0.0%) | 0.580 |
| Initial antifungal agent [n (%)] | ||||
| Fluconazole | 40 (34.2%) | 32 (34.4%) | 8 (33.3%) | 0.921 |
| Echinocandin | 46 (39.3%) | 36 (38.7%) | 10 (41.7%) | 0.791 |
| Voriconazole | 11 (9.4%) | 9 (9.7%) | 2 (8.3%) | > 0.999 |
| Prior antifungal exposure [n (%)] | 10 (8.5%) | 6 (6.4%) | 4 (16.7%) | 0.235 |
| Appropriate Antifungal therapy c [n (%)] | 43 (36.8%) | 35 (37.6%) | 8 (33.3%) | 0.697 |
| Delay in initiation of empiric antifungal treatment d [n (%)] | 100 (85.5%) | 82 (88.2%) | 18 (75.0%) | 0.103 |
Abbreviations: CVC central venous catheter, PICC Peripherally inserted central catheters, CRBSI catheter-related bloodstream infection;
aCentral venous catheter removed within 48 h after the first positive sample
bAll patients receiving systemic drug therapy for ≥3 days within 2 weeks prior to candidaemia onset
cAntifungal therapy was defined as appropriate if the isolated Candida spp. was sensitive to the chosen antifungal agent, and the antifungal agent was used with adequate dosages (like Fluconazole: loading dose of 800 mg [12 mg/kg], then 400 mg [6 mg/kg] daily; Caspofungin: loading dose of 70 mg, then 50 mg daily)
dThe delay of empiric antifungal treatment was considered as initial use more than 12 h after the report of first positive blood sample