Gonzalez-Lara MF, et al. - Ths retrospective analysis was performed to assess the effect of inappropriate antifungal treatment according to recent breakpoints on 30-day mortality of Candida Bloodstream Infection (CBSI). According to Clinical & Laboratory Standards Institute (CLSI) 2012, appropriate antifungal therapy did not have an impact on mortality. Due to disease severity and comorbidities, mortality of CBSI remained high. Early antifungal therapy and catheter removal could reduce it.

Methods

• The researchers analyzed data on CBSI episodes from 2 tertiary-care centers, treated >72 h, from June 2008 to July 2014.
• They registered antifungal therapy and 30-day mortality.
• According to current CLSI breakpoints, inappropriate antifungal treatment was adjusted with 30-day mortality-related co-variates.

Results

• The researchers analyzed 149 episodes of CBSI.
• C. Albicans (40%), C. Tropicalis (23%) and C. glabrata complex (20%) were the most frequent species.
• In this study, 10.7% received inappropriate treatment according to the 2012 CLSI.
• The 30-day mortality was 38%.
• In multivariate analysis, severe sepsis [Odds ratio (OR) 3.4; 95% CI 1.3-8.4], cirrhosis (OR 36; 95% CI 12.2-605), early central venous catheter removal (OR 0.23; 95% CI 0.08-0.66) and previous antifungal therapy (OR 0.15; 95%CI 0.03-0.62), were associated with 30-day mortality, whereas inappropriate antifungal treatment was not (OR 0.19; 95% CI 0.03-1.2).