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Mortality-associated factors of candidemia: a multi-center prospective cohort in Turkey

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Abstract

Candidemia may present as severe and life-threatening infections and is associated with a high mortality rate. This study aimed to evaluate the risk factors associated with 30-day mortality in patients with candidemia. A multi-center prospective observational study was conducted in seven university hospitals in six provinces in the western part of Turkey. Patient data were collected with a structured form between January 2018 and April 2019. In total, 425 episodes of candidemia were observed during the study period. Two hundred forty-one patients died within 30 days, and the 30-day crude mortality rate was 56.7%. Multivariable analysis found that SOFA score (OR: 1.28, CI: 1.154–1.420, p < 0.001), parenteral nutrition (OR: 3.9, CI: 1.752–8.810, p = 0.001), previous antibacterial treatment (OR: 9.32, CI: 1.634–53.744, p = 0.012), newly developed renal failure after candidemia (OR: 2.7, CI: 1.079–6.761, p = 0.034), and newly developed thrombocytopenia after candidemia (OR: 2.6, CI: 1. 057–6.439, p = 0.038) were significantly associated with 30-day mortality. Central venous catheter removal was the only factor protective against mortality (OR: 0.34, CI:0.147–0.768, p = 0.010) in multivariable analysis. Candidemia mortality is high in patients with high SOFA scores, those receiving TPN therapy, and those who previously received antibacterial therapy. Renal failure and thrombocytopenia developing after candidemia should be followed carefully in patients. Antifungal therapy and removing the central venous catheter are essential in the management of candidemia.

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Authors and Affiliations

  1. Infectious Diseases and Clinical Microbiology, Pamukkale University, Denizli, Turkey

    Murat Kutlu & Selda Sayın-Kutlu

  2. Infectious Diseases and Clinical Microbiology Department, Pamukkale University, School of Medicine, Kınıklı/Pamukkale, 20070, Denizli, Turkey

    Murat Kutlu

  3. Infectious Diseases and Clinical Microbiology, Dokuz Eylul University, İzmir, Turkey

    Sema Alp-Çavuş, Oya Eren Kutsoylu, Vildan Avkan-Oğuz & Nur Yapar

  4. Infectious Diseases and Clinical Microbiology, Adnan Menderes University, Aydın, Turkey

    Şerife Barçın Öztürk & Bülent Ertuğrul

  5. Infectious Diseases and Clinical Microbiology, Ege University, İzmir, Turkey

    Meltem Taşbakan, Gülşen Mermut & Hüsnü Pullukcu

  6. Medical Microbiology, Akdeniz University, Antalya, Turkey

    Betil Özhak

  7. Infectious Diseases and Clinical Microbiology, Süleyman Demirel University, Isparta, Turkey

    Onur Kaya

  8. Infectious Diseases and Clinical Microbiology, Celal Bayar University, Manisa, Turkey

    Şebnem Şenol-Akar & Çiğdem Banu Çetin

  9. Infectious Diseases and Clinical Microbiology, Akdeniz University, Antalya, Turkey

    Özge Turhan

  10. Medical Microbiology, Ege University, İzmir, Turkey

    Dilek Yeşim-Metin

  11. Medical Microbiology, Pamukkale University, Denizli, Turkey

    Çağrı Ergin

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  1. Murat Kutlu
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Correspondence to Murat Kutlu.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University of Pamukkale ethics committee (date and no: 14.11.2017–15).

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Kutlu, M., Sayın-Kutlu, S., Alp-Çavuş, S. et al. Mortality-associated factors of candidemia: a multi-center prospective cohort in Turkey. Eur J Clin Microbiol Infect Dis 41, 597–607 (2022). https://doi.org/10.1007/s10096-021-04394-0

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