Epidemiology and Clinical Insights of Catheter-Related Candidemia in Non-ICU Patients with Vascular Access Devices.

INTRODUCTION

Vascular access devices (VADs), namely peripheral VADs (PVADs) and central venous VADs (CVADs), are crucial in both intensive care unit (ICU) and non-ICU settings. However, VAD placement carries risks, notably catheter-related bloodstream infections (CRBSIs). spp. is a common pathogen in CRBSIs, yet its clinical and microbiological characteristics, especially in non-ICU settings, are underexplored.

METHODS

We conducted a monocentric, retrospective observational study at Luigi Sacco Hospital from 1 May 2021 to 1 September 2023. We reviewed medical records of non-ICU adult patients with CVADs and PVADs. Data on demographics, clinical and laboratory results, VAD placement, and CRBSI occurrences were collected. Statistical analysis compared spp. CRBSI and bacterial CRBSI groups.

RESULTS

Out of 1802 VAD placements in 1518 patients, 54 cases of CRBSI were identified, and spp. was isolated in 30.9% of episodes. The prevalence of CRBSI was 3.05%, with spp. accounting for 0.94%. Incidence rates were 2.35 per 1000 catheter days for CRBSI, with and non-albicans at 0.47 and 0.26 per 1000 catheter days, respectively-patients with spp. CRBSI had more frequent SARS-CoV-2 infection, COVID-19 pneumonia, and hypoalbuminemia.

CONCLUSIONS

During the COVID-19 pandemic, spp. was a notable cause of CRBSIs in our center, underscoring the importance of considering spp. in suspected CRBSI cases, including those in non-ICU settings and in those with PVADs.