Candida catheter sepsis

In a rat model of neonatal sepsis, recombinant HL or talactoferrin was shown to improve survival (Venkatesh et al., 2007). In ex vivo studies, HL increased synergy of commonly used antibiotics against coagulase-negative staphylococcus and Candida (Venkatesh and Rong, 2008) and reduced biofilm of infected catheters (Venkatesh et al., 2009). 

One infant died of Candida Sepsis on the 5th day of infusion no other catheter complications were encountered. Three other infants died from causes unrelated to the intravenous alimentation. 

The incidence of Candidiasis reported in this series is disturbing because of the recent association of Candidiasis with parenteral nutrition, by Ashcraft and Leape (5). The work of MacMillan, Law and Holder, however, documents the increasing problem of Candida in the burned child (6). Because of the number of variables involved, it is difficult in this series to assess the relationship between Candidiasis and central venous nutritional supplementation. The clinician caring for this type of patient, however, should be aware of this etiologic possibility when sepsis presents and treat when present by removing catheters and giving Amphotericin B. 

The association of duration of catheterization, with the incidence of catheter positive sepsis has been widely debated. Some believe duration to be a factor (14,18,22,31), and others do not (10,44). The latter group believe that the catheter is contaminated at the time of introduction. In our experience (Table 4) duration does appear to be a factor. The ability of the nutritive solutions to support bacterial and fungal growth is now well established (12, 14,43). Candida albicans will grow particularly well in casein hydrolysates with dextrose, and in intravenous soy bean fat emulsions. 

Catheter-related sepsis in patients on parenteral nutrition is usually caused by Gram-positive or Gram-negative bacteria or by Candida species. However, other organisms can be involved in patients who are immunocompromised [80 ]. 

A 41-year-old Caucasian man presenting sudden unconsciousness, tachyarrhythmia and fever of 40 °C was referred to the ICU. Sepsis was suspected and intravenous antibiotics were initiated. Liver failure was diagnosed but patient started to recover slowly. On day 23, a culture of a central venous catheter tip was positive with Candida glabrata. Anidulafundin was started with... 

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