Factors influencing outcome in hospitalized patients with candidemia

Candidemia is an important cause of mortality in hospitalized patients with certain risk factors. We reviewed 76 evaluable patients with hospital-acqui red candidemia to determine which risk factors significantly affected outcome. During a 10-year period, 76 patients had at least one positive antemortem blood sample drawn peripherally and had charts available for review. Individual risk factors and their relationship to mortality were compared. To determine which of these factors taken together would predict mortality, we used a stepwise logistic regression analysis. Overall mortality in this study was 60.5%. Those factors that significantly affected outcome were duration of hospitalization, leukemia, renal failure, immune status, chemotherapy, neutropenia, colonization, concurrent bacteremia, dissemination, line-associated candidemia, and gastrointestinal portal of entry. By multivariate analysis, renal failure, chemotherapy, and concurrent bacteremia significantly contributed to mortality. Increased chances of survival correlated with line-related candidemia. Duration of hospitalization (>50 days) also predicted survival. Treatment with amphotericin Β was not significantly related to the outcome.