Candida bloodstream infection in patients with cancer: A retrospective analysis of an 11-year period

Abstract

Background: Candida bloodstream infection (CBSI) is a growing problem among patients with cancer.

Aim: To describe the main clinical and microbiological characteristics in patients with cancer who suffer CBSI.

Methods: We reviewed the clinical and microbiological characteristics of all patients with CBSI diagnosed between January 2010 and December 2020, at a tertiary-care oncological hospital. Analysis was done according to the Candida species found. Multivariate logistic regression analysis was used to determine the risk factors associated with 30-day mortality.

Results: There were 147 CBSIs diagnosed, 78 (53%) in patients with hematologic malignancies. The main Candida species identified were Candida albicans (n=54), Candida glabrata (n=40) and Candida tropicalis (n=29). C. tropicalis had been mainly isolated from patients with hematologic malignancies (79.3%) who had received chemotherapy recently (82.8%), and in patients with severe neutropenia (79.3%). Seventy-five (51%) patients died within the first 30 days, and the multivariate analysis showed the following risk factors: severe neutropenia, a Karnofsky Performance Scale score under 70, septic shock, and not receiving appropriate antifungal treatment.

Conclusions: Patients with cancer who develop CBSI had a high mortality related with factors associated with their malignancy. Starting an empirical antifungal therapy the soonest is essential to increase the survival in these patients.

Keywords: Antifungal; Antifúngicos; Cancer; Candida bloodstream infection; Candidemia; Cáncer; Mortalidad; Mortality.