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
DOIs
StatePublished - Apr 1 1992

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ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Lecciones, J. A., Lee, J. W., Navarro, E. E., Witebsky, F. G., Marshall, D., Steinberg, S. M., Pizzo, P. A., & Walsh, T. J. (1992). Vascular Catheter-Associated Fungemia in Patients with Cancer: Analysis of 155 Episodes. Clinical Infectious Diseases, 14(4), 875-883. https://doi.org/10.1093/clinids/14.4.875