Table 2. Risk factors for in-hospital death among 1,040 persons with culture-confirmed candidemia at sentinel hospitals, South Africa, 2012–2017*.
| Variable | No. patients† | No. deaths | Case-fatality ratio, % | Crude OR (95% CI) | LRT p value |
|---|---|---|---|---|---|
| HIV status | 1,040 | ||||
| Seronegative | 614 | 230 | 37 | Referent | <0.001 |
| Seropositive |
426 |
228 |
54 |
1.92 (1.50–2.47) |
|
| Age group, y | 1,037 | ||||
| <18 | 226 | 46 | 20 | Referent | <0.001 |
| 18–44 | 427 | 199 | 47 | 3.42 (2.35–4.97) | |
| 45–64 | 283 | 152 | 54 | 4.54 (3.04–6.77) | |
| >65 | 101 | 61 | 60 | 5.97 (3.57–9.97) | |
| Missing |
3 |
|
|
|
|
| Sex | 1,040 | ||||
| F | 498 | 215 | 43 | Referent | 0.59 |
| M |
542 |
243 |
45 |
1.07 (0.84–1.37) |
|
| Province | 1,040 | ||||
| Other province | 495 | 232 | 50 | Referent | 0.21 |
| Gauteng |
545 |
226 |
46 |
0.86 (0.67–1.09) |
|
| Year | 1,040 | ||||
| 2012 | 139 | 52 | 37 | Referent | 0.05 |
| 2013 | 185 | 74 | 40 | 1.11 (0.71–1.75) | |
| 2014 | 100 | 51 | 51 | 1.74 (1.03–2.93) | |
| 2015 | 91 | 38 | 42 | 1.20 (0.70–2.06) | |
| 2016 | 273 | 115 | 42 | 1.22 (0.80–1.85) | |
| 2017 |
252 |
128 |
51 |
1.73 (1.13–2.64) |
|
| Community-onset infection, <72 h preadmission | 1,035 | ||||
| No | 747 | 334 | 45 | Referent | 0.38 |
| Yes | 288 | 120 | 42 | 0.88 (0.67–1.16) | |
| Missing |
3 |
|
|
|
|
| ICU admission | 1,023 | ||||
| No | 509 | 202 | 40 | Referent | 0.005 |
| Yes | 514 | 249 | 48 | 1.43 (1.11–1.83) | |
| Missing |
17 |
|
|
|
|
| CVC in situ | 1,011 | ||||
| No | 466 | 193 | 41 | Referent | 0.21 |
| Yes | 545 | 247 | 45 | 1.17 (0.91–1.51) | |
| Missing |
29 |
|
|
|
|
| Total parenteral nutrition | 1,004 | ||||
| No | 759 | 333 | 44 | Referent | 0.70 |
| Yes | 245 | 104 | 42 | 0.94 (0.71–1.26) | |
| Missing |
36 |
|
|
|
|
| Quick Pitt score >2‡ | 652 | ||||
| No | 503 | 188 | 37 | Referent | <0.001 |
| Yes | 149 | 89 | 60 | 2.49 (1.71–3.61) | |
| Missing |
388 |
|
|
|
|
| Candida species | 946 | ||||
| C. albicans | 425 | 221 | 52 | Referent | <0.001 |
| Other Candida species | 521 | 204 | 39 | 0.59 (0.46–0.77) | |
| Missing |
94 |
|
|
|
|
| Mixed Candida species | 1,040 | ||||
| No | 1,007 | 445 | 44 | Referent | 0.58 |
| Yes |
33 |
13 |
40 |
0.82 (0.40–1.67) |
|
| Candida species resistant to fluconazole, voriconazole, or an echinocandin§ | 764 | ||||
| No | 610 | 283 | 46 | Referent | 0.35 |
| Yes | 154 | 65 | 42 | 0.84 (0.59–1.21) | |
| Missing |
276 |
|
|
|
|
| Receipt of systemic antifungal treatment | 1,010 | ||||
| No | 310 | 187 | 60 | Referent | <0.001 |
| Yes | 700 | 254 | 36 | 0.37 (0.28–0.49) | |
| Missing |
30 |
|
|
|
|
| Inappropriate antifungal treatment for candidemia¶ | 419 | ||||
| No | 381 | 140 | 37 | Referent | 0.52 |
| Yes | 38 | 16 | 42 | 1.25 (0.64–2.46) | |
| Missing |
621 |
|
|
|
|
| Removal of CVC | 488 | ||||
| No | 127 | 71 | 56 | Referent | 0.001 |
| Yes | 361 | 141 | 39 | 0.51 (0.34–0.76) | |
| Missing | 552 |
*CVC, central venous catheter; ICU, intensive care unit; LRT, likelihood ratio test; OR, odds ratio. †Total numbers for each category indicate number of patients for whom that information was available. ‡Quick Pitt score was calculated as the sum of individual scores for temperature <35°C (1), systolic blood pressure <90 mm Hg (1), cardiac arrest (1), mechanical ventilation (1), and altered mental status (1) at time of diagnosis of candidemia. §Resistance was defined on the basis of Clinical and Laboratory Standards Institute Candida species–specific breakpoints (18). ¶Inappropriate treatment was defined as treatment with an antifungal agent to which the Candida species was resistant.