SEPSIS DUE TO RHODOTORULA RELATED TO USE OF INDWELLING CENTRAL VENOUSCATHETERS

With increased use of surgically implanted silastic central venous cat heters, there has been an increase in the recovery from blood cultures at Memorial Sloan-Kettering Cancer Center (New York) of environmental and skin organisms including the red yeast Rhodotorula. From 1985 thr ough 1989, 23 patients had catheter-related Rhodotorula sepsis. All 23 patients had indwelling central venous catheters that had been in pla ce from 1 to 22 months (average, 9.3 months) prior to the detection of fungemia. All patients had blood drawn both through the catheter and from a peripheral source, and only one patient had a peripheral blood culture positive for Rhodotorula. Colony counts of yeast from the cath eter cultures often exceeded 100 (15 patients) and even 1,000 (seven p atients) cfu/mL of blood. Thirteen of the patients were treated with a ntifungal therapy and had the catheter removed, and five patients rece ived antifungal therapy without catheter removal (suggesting that comp ulsory removal of the catheter may not always be required). Five patie nts had the catheter removed without antifungal therapy. All patients survived the fungemic episode and experienced no recurrence of the inf ection.