CLINICAL-EVALUATION OF CATHETER-RELATED FUNGEMIA AND BACTEREMIA

Fourty-four patients with catheter-related infection admitted to Hokus ho Central Hospital between 1985 and 1991 were studied retrospectively . The rate of catheter-related fungemia or bacteremia to all correspon ding cases of fungemia and bacteremia increased from 7.7% in 1985 to 2 8.8% in 1991. The isolated pathogens were Candida parapsilosis (8 stra ins), Candida tropicalis (6 strains), methicillin-resistant Staphyloco ccus aureus (MRSA) (6 strains), methicillin-sensitive S-aureus (MSSA) (5 strains) and Streptococcus epidermidis (3 strains). Bacteremia occu rred after catherization of the femoral vein for a mean duration of 37 days. The period was significantly shorter than that after catherizat ion of the subclavian vein (56 days). The major isolates from the subc lavian vein were Candida spp (14/17, 82.4%), followed by MRSA (1/17, 5 .9%) and MSSA (1/17, 5.9%), while isolates from the femoral vein were candida spp (6/16, 37.5%), MRSA (5/16, 31.3%) and MSSA (3/16, 20.8%). Catheter removal alone did not improve the clinical condition, particu larly in MRSA bacteremia; the combination of antimicrobial therapy and removal of the catheter was necessary for a better prognosis.