Creation and assessment of a clinical predictive model for candidaemia in patients with candiduria

Katie Wang, Kevin Hsueh, Ryan Kronen, Charlotte Lin, Ana S. Salazar, William G. Powderly, Andrej Spec

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Candidaemia is the most common clinical presentation of invasive candidiasis and is a major cause of morbidity and mortality. Candiduria is a predictor for candidaemia; however, patient characteristics that are associated with concurrent candidaemia in the setting of candiduria are unclear. Identifying these characteristics could aid in the early detection of systemic disease. We performed a retrospective cohort analysis of hospitalised patients with candiduria at our institution over a 13-year period. Our evaluation of patient characteristics included demographics, comorbidities, medications, procedures, devices, vital signs and laboratory values. We developed a multivariable logistic model to identify factors associated with candidaemia in patients with candiduria. We identified 4240 patients with candiduria, 263 (6.2%) of whom had candidaemia. Predictors for increased risk of candidaemia with candiduria included hospitalisations > 12 days, central venous catheter, parenteral nutrition, haematological and gynaecological malignancy, and receipt of β-lactam/β-lactamase inhibitors. Vital signs and laboratory values associated with candidaemia included elevated heart rate, temperature and creatinine, along with neutropenia and neutrophilia. Factors that demonstrated a decreased risk of candidaemia included diabetes mellitus, gastrostomy and urinary catheter with antibiotic use. The c-statistic was 0.741 (95% CI, 0.710-0.772). We identified a set of clinical characteristics that can predict the presence of candidaemia with candiduria.

Original languageEnglish
Pages (from-to)554-561
Number of pages8
JournalMycoses
Volume62
Issue number7
DOIs
StatePublished - Jul 2019

Keywords

  • Candida spp
  • candidemia
  • candiduria
  • clinical prediction model
  • colonisation
  • protective factors
  • risk factors
  • systemic infection

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