Glucocorticoid use and parenteral nutrition are risk factors for catheter-related bloodstream infection: a retrospective study.

BACKGROUND

Catheter-related candidemia (CRC) is a serious catheter-related bloodstream infection (CRBSI) caused by spp., with higher mortality than CRBSIs caused by other organisms.

OBJECTIVE

To identify the risk factors for CRBSI. The clinical characteristics of 297 patients with CRBSI in a local hospital from January 2007 to June 2015 were collected, including 33 CRBSI and 264 non- CRBSI.

METHOD

The associations of CRBSI with the clinical variables were examined using univariate and multivariate analyses.

RESULTS

Multivariate analysis showed that glucocorticoid use (odds ratio [OR] = 10.313, 95% confidence interval [CI] = 2.032-52.330, = 0.005) and parenteral nutrition (OR = 5.400, 95% CI = 0.472-61.752, = 0.0175) were independent risk factors for CRBSI. The most prevalent species were (42.4%) and (36.36%). Of the 33 CRBSI cases, 31 (93.93%) had indwelling central venous catheters (CVC) for ≥14 d. The mortality of CRBSI was remarkably higher than that of bacteria CRBSI. Patients with timely catheter removal and appropriate antifungal treatment had dramatically increased 28-d survival compared with those with untimely catheter removal + inappropriate antifungal treatment (88.89% vs. 0, = 0.006).

CONCLUSION

The study identified glucocorticoid use and parenteral nutrition as independent risk factors for CRBSI. The outcome of candidemia was associated with the duration of CVC indwelling and antifungal treatment.