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.