Vascular catheter-associated fungemia in patients with cancer

Analysis of 155 episodes

Julius A. Lecciones, James W. Lee, Eileen E. Navarro, Frank G. Witebsky, Dorie Marshall, Seth M. Steinberg, Philip A. Pizzo, Thomas J. Walsh

Research output: Contribution to journalArticle

Abstract

We reviewed all 155 episodes of central venous catheter-associated fungemia among inpatients at the National Cancer Institute during a 10-year period. Candida species accounted for 98% of episodes. Fungemia was documented by culture of blood drawn through catheters in 50% of cases and by culture of both catheter-drawn and peripheral blood in 39%; mortality and the rate of dissemination were similar for these two groups. Four management strategies were used: catheter removal, antifungal therapy (with amphotericin B), both, or neither; indications for the use of both modes of treatment included fever, neutropenia, long-term indwelling catheterization, positive cultures of both catheter-drawn and peripheral blood, isolation of Candida tropicalis, and fungal isolation from two or more blood cultures. Disseminated fungal infection was documented in 82% of cases with these features but also in 35% of the less severe cases treated only with catheter removal. In addition, nine (82%) of 11 cases managed only with antifungal therapy had a negative outcome (either death from disseminated infection or the recurrence of fevers and/or fungemia), a finding suggesting that intravascular catheters should be removed in fungemia. Virtually all cases of catheter-associated fungemia in patients with cancer are clinically significant and require prompt therapy with amphotericin B.

Original languageEnglish (US)
Pages (from-to)875-883
Number of pages9
JournalClinical Infectious Diseases
Volume14
Issue number4
StatePublished - Apr 1992
Externally publishedYes

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Fungemia
Vascular Access Devices
Catheters
Neoplasms
Amphotericin B
Fever
Candida tropicalis
National Cancer Institute (U.S.)
Central Venous Catheters
Mycoses
Therapeutics
Neutropenia
Candida
Catheterization
Inpatients
Recurrence
Mortality
Infection

ASJC Scopus subject areas

  • Immunology

Cite this

Lecciones, J. A., Lee, J. W., Navarro, E. E., Witebsky, F. G., Marshall, D., Steinberg, S. M., ... Walsh, T. J. (1992). Vascular catheter-associated fungemia in patients with cancer: Analysis of 155 episodes. Clinical Infectious Diseases, 14(4), 875-883.

Vascular catheter-associated fungemia in patients with cancer : Analysis of 155 episodes. / Lecciones, Julius A.; Lee, James W.; Navarro, Eileen E.; Witebsky, Frank G.; Marshall, Dorie; Steinberg, Seth M.; Pizzo, Philip A.; Walsh, Thomas J.

In: Clinical Infectious Diseases, Vol. 14, No. 4, 04.1992, p. 875-883.

Research output: Contribution to journalArticle

Lecciones, JA, Lee, JW, Navarro, EE, Witebsky, FG, Marshall, D, Steinberg, SM, Pizzo, PA & Walsh, TJ 1992, 'Vascular catheter-associated fungemia in patients with cancer: Analysis of 155 episodes', Clinical Infectious Diseases, vol. 14, no. 4, pp. 875-883.
Lecciones JA, Lee JW, Navarro EE, Witebsky FG, Marshall D, Steinberg SM et al. Vascular catheter-associated fungemia in patients with cancer: Analysis of 155 episodes. Clinical Infectious Diseases. 1992 Apr;14(4):875-883.
Lecciones, Julius A. ; Lee, James W. ; Navarro, Eileen E. ; Witebsky, Frank G. ; Marshall, Dorie ; Steinberg, Seth M. ; Pizzo, Philip A. ; Walsh, Thomas J. / Vascular catheter-associated fungemia in patients with cancer : Analysis of 155 episodes. In: Clinical Infectious Diseases. 1992 ; Vol. 14, No. 4. pp. 875-883.
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