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. 2021 May 31;7(6):442.
doi: 10.3390/jof7060442.

Risk Factors for Mortality in Colombian Patients with Candidemia

Jorge Alberto Cortés  1 , Anita María Montañez  1 , Ana María Carreño-Gutiérrez  1 , Patricia Reyes  2 , Carlos Hernando Gómez  3 , Angela Pescador  3 , Beatriz Ariza  4 , Fernando Rosso  5
Affiliations

Risk Factors for Mortality in Colombian Patients with Candidemia

Jorge Alberto Cortés et al. J Fungi (Basel). .

Abstract

The aim of the study was to describe the microbiology and susceptibility profile of candidemia and to identify the risk factors associated with mortality in Colombia. A cohort of patients was followed for 30 days during 2008 to 2010. Microbiological identification and susceptibility assessments were performed in a reference centre. Demographic, clinical and treatment variables were evaluated for their associations with mortality. A parametric survival regression analysis was used to identify the risk factors associated with mortality. A total of 109 patients with candidemia in four hospitals in Colombia were identified, with a median age of 30 years old. C. parapsilosis was the most frequently identified microorganism (38.5%); the susceptibility of all isolates was high to fluconazole and anidulafungin, except for C. glabrata isolates. The overall mortality was 35.7%, and the risk factors associated with mortality included lack of antifungal treatment (HR 5.5, 95% CI 3.6-11.4), cancer (HR 3.9, 95% CI 2.3-8.0), diabetes (HR 2.5, 95% CI 1.03-6.4), and age (HR 1.13 per every 10 years, 95% CI 1.02-1.24). Catheter removal was associated with a low mortality rate (HR 0.06, 95% CI 0.00-0.49). Prompt antifungal treatment, better glycemic control and catheter removal should be prioritized in the management of candidemia.

Keywords: Candida; Candida albicans; candidemia; intensive care units; mortality; mycoses; survival analysis.

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Conflict of interest statement

J.A.C. declares research support by Pfizer. Other authors (P.R., C.H.G., B.A., A.M.M., A.P., F.R., A.M.C.-G.) declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Survival analysis of patients with candidemia according to the time of start of treatment. Note: The coloured shadow shows the 95% confidence interval. Time was counted beginning the day the blood sample was taken.
Figure 2
Figure 2
Survival analysis of patients with candidemia according to the presence of cancer. Note: The coloured shadow shows the 95% confidence interval.
See this image and copyright information in PMC

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