Clinical features and outcomes of Candidaemia in cancer patients: Results from Pakistan.

ABSTRACT

OBJECTIVE: To evaluate clinical risk factors and outcomes among cancer patients with candidaemia at a large cancer treatment centre. METHODS: The retrospective study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised data related to all cancer patients with a positive blood culture for candida species between January 1995 and December 2013. RESULTS: A total of 311 patients were identified and there were 16 positive candida cultures among every 1000 (1.6%) cultures positive for any microorganism. Patients with haematological malignancies (adjusted odds ratio2.23), those in shock (adjusted odds ratio 9.48) were significantly more likely to die during the index hospitalisation, while patients with candida albicans isolated from the blood culture (adjusted odds ratio 0.47) and those who received antifungal agent based on the sensitivity report of the fungal culture (adjusted odds ratio0.32) were significantly less likely to die. Receipt of antifungal agents on an empirical basis before a positive culture was not significantly associated with mortality (p>0.05). CONCLUSIONS: No statistically significant risk factor for candidemia was identified, but haematological malignancies, shock and candidaemia due to non-albicans species were predictors of mortality during index hospitalisation.