630. The Use of Statins and Clinical Outcomes of Blood Stream Infection Due to Candida Species
Session: Abstracts: Mycology
Friday, October 22, 2010

Background: Bloodstream infection due to Candida (CBSI) contributes to morbidity and mortality in hospitalized patients. We had previously shown that statin therapy reduced mortality among patients with bacteremia within our medical center. The impact of statin use in outcomes of CBSI has not been well defined.

Methods: A retrospective review of CBSI was conducted 2003-8. Statin use was defined as drug given before and during time of CBSI. Comparisons between statin and no statin use were made using 2-tailed Fisher's exact test for categorical variables and unpaired t test for continuous variables.

Results: 124 CBSIs were documented over 5 yrs. C. albicans and non-C. albicans species were each responsible for 48% of CSBI, respectively, with the remaining 4% due to mixed species. While on statin therapy, 14/124 (11%) developed CBSI.

All

Statin

No Statin

N (%)

124

14

110

Age: mean yrs SD

6414

6914

6414

Co-morbid conditions

Hypertension

76 (61%)

9 (64%)

67 (61%)

Diabetes

41 (33%)

8 (57%)

33 (30%)

Chronic hepatitis C

25 (20%)

4 (29%)

21 (19%)

HIV/AIDS

11 (9%)

2 (14%)

9 (8%)

Catheter in place at time of CBSI

108 (87%)

10 (71%)

98 (89%)

Required ICU care

79 (64%)

9 (64%)

70 (64%)

Length of stay: median days (range)

43 (1-901)

39 (7-144)

43 (1-901)

Mortality attributable to CBSI

2 (2%)

0 (0%)

2 (2%)

Overall Mortality

57 (46%)

6 (43%)

51 (46%)

Conclusion: CBSI contributed significantly to overall mortality in our patients. The majority of patients required intensive care management had substantial comorbid illness and were of advanced age. Our definition required statin to be continued after CBSI identification. No differences in clinical outcomes were seen for patients who received or did not receive statin therapy at the time of their candidemia.  


Subject Category: M. Mycology including clinical and basic studies of fungal infections

Speakers:
Meredith L. Welch, MD , Department of Medicine, Division of Infectious Diseases, George Washington University Medical Center, Washington, DC
Angelike P. Liappis, MD , Medical Service, Infectious Diseases Section, Washington DC Veterans Affairs Medical Center and The George Washington University Medical Center, Washington, DC
Virginia L. Kan, MD , Medical Service, Infectious Diseases Section, Veterans Affairs Medical Center District of Columbia, Washington, DC

Disclosures:

M. L. Welch, None

A. P. Liappis, None

V. L. Kan, None

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