Candidemia - risk factors

Q: All of the following are the risk factors for candidemia in ICU except?

A) Central venous catheters (CVC)
B) Total parenteral nutrition (TPN)
C) Hemodialysis
D) Broad-spectrum antibiotics
E) Daily bathing with chlorhexidine


Answer:  E 

Candidemia in ICU is a huge burden and carries a high mortality. All of the above except choice E are the risk factors for candidemia in ICU. Even a mere suspicion of it should call for a consideration to removal of CVC. Quick de-escalation of broad-spectrum antibiotics should be a standard of care. Also, trauma and surgical units may be prone to higher incidence of candidemia. As per recent updated clinical practice guideline for the management of candidiasis (2016) from the Infectious Diseases Society of America (IDSA), daily bathing of ICU patients with chlorhexidine has shown to decrease the incidence of bloodstream infections in general, and candidemia in particular.



Reference:

Pappas PG, Kauffman CA, Andes DR, et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis 2016; 62:e1.