Candidaemia in patients with dialysis‐dependent acute renal failure: aetiology, predisposing and prognostic factors

Abstract

The higher prevalence of candidaemia in ARF(d) patients is due to their underlying illnesses and multiplicity of predisposing factors, rather than ARF and dialysis therapy per se. Predisposing factors include SLE, indwelling central venous catheter, multiple antibiotic usage, and corticosteroid therapy. Prompt anti-fungal therapy and catheter removal should be mandatory for ARF(d) patients with candidaemia.

Surveillance and characterization of Candida bloodstream infections in a Serbian tertiary care hospital

“…It is believed that Th1 cell responses characterize the carriage of saprophytic yeast and the resistance to disease in healthy individuals, whereas on the other side Th2 responses are predominantly connected with the pathology observed in immunocompromised hosts. Serious primary diseases, such as diabetes, chronic renal failure, malignant diseases and SLE, could lead to the depression of humoral and cellular immunity, which are the basic defensive mechanisms preventing Candida systemic/invasive infections [3]. In our survey, all patients with CBSI suffered from serious primary diseases, conditions or displayed other risk factors for the development of CBSI (Table s2).…”

“…The number of white blood cells (WBC) varied from 4,500 to 17,000 cells/mm 3 . The mean value of WBC count in the case group was higher (p=0.0043) than the WBC count for the patients from the control group.…”

“…Indirectly, the treatment with broad-spectrum antibiotics that influences Candida-colonization of GIT, followed by a translocation of the fungi into the blood, could be a riskfactor for candidemia [3]. On the other hand, contaminated catheters enable a direct inoculation of Candida spp.…”

“…The epidemiological scenario of Candida BSI (CBSI) varies between different geographical regions. In Europe: i) the incidence of CBSI ranges from 3 to 8.6 cases per 100,000 population per year [2]; ii) the mortality of candidemia is 38% in hospitalized patients, and in patients with malignancies up to 70% [3]. In Taiwan, CBSI are the second most common cause of hospitalacquired sepsis (after bacteremia by Staphylococcus species) [4].…”

“…Because of the existence of noncharacteristic symptoms and clinical signs, it is very important to consider the risk factors and predisposing diseases in patients. Well-known risk factors include hematological and endocrine diseases, acquired and congenital immunodeficiency, use of broad-spectrum antibiotics and immunosuppressant drugs (steroids), prolonged hospitalization, especially in ICUs, invasive medical procedures, parenteral nutrition, presence of a central venous catheter and hemodialysis [3,4]. CBSI are frequently associated with the formation of biofilms, growth of Candida organisms on medical devices such as venous or urinary catheters.…”