TY - JOUR
T1 - Candidemia in patients with head and neck cancer
T2 - mortality and a novel risk factor
AU - Uraguchi, Kensuke
AU - Makino, Takuma
AU - Kariya, Shin
AU - Noda, Youhei
AU - Marunaka, Hidenori
AU - Doi, Akira
AU - Kozakura, Kenichi
AU - Takao, Soshi
AU - Ando, Mizuo
N1 - Funding Information:
This work was supported by JSPS KAKENHI (Grants-in-Aid for Scientific Research) grant number 19K1880801.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2022/7
Y1 - 2022/7
N2 - Purpose: Candidemia is a bloodstream infection (BSI) by Candida spp. and is associated with high mortality. However, there have been few reports about BSI in head and neck cancer (HNC). We aimed to evaluate the impact of candidemia in patients with HNC and compared it with bacteremia. Study design: A multicenter retrospective study. Methods: We retrospectively analyzed 83 BSI episodes in HNC (2011 to 2020) and divided them into the candidemia and bacteremia groups. We then compared the survival rate and risk factors for candidemia between the groups. Results: The overall cumulative incidence (risk) of candidemia in BSI was 12 out of 83 episodes (14.5%). The 1-year mortality for the bacteremia and candidemia groups was 33.3% and 58.3%, respectively (log-rank p = 0.041). Broad-spectrum antibiotics (odds ratio [OR]: 29.5; 95% confidence interval [CI], 2.49–350), mucositis (OR 11.0; 95% CI, 1.52–80.1), and malignant wounds (OR 79.5; 95% CI 1.33–4737) were significant risk factors for candidemia in HNC. Conclusions: Candidemia causes high mortality in patients with HNC. To our knowledge, malignant wounds have not been previously reported as a risk factor for candidemia. For early diagnosis and treatment of candidemia, risk factors should be considered, and antifungal therapy started earlier.
AB - Purpose: Candidemia is a bloodstream infection (BSI) by Candida spp. and is associated with high mortality. However, there have been few reports about BSI in head and neck cancer (HNC). We aimed to evaluate the impact of candidemia in patients with HNC and compared it with bacteremia. Study design: A multicenter retrospective study. Methods: We retrospectively analyzed 83 BSI episodes in HNC (2011 to 2020) and divided them into the candidemia and bacteremia groups. We then compared the survival rate and risk factors for candidemia between the groups. Results: The overall cumulative incidence (risk) of candidemia in BSI was 12 out of 83 episodes (14.5%). The 1-year mortality for the bacteremia and candidemia groups was 33.3% and 58.3%, respectively (log-rank p = 0.041). Broad-spectrum antibiotics (odds ratio [OR]: 29.5; 95% confidence interval [CI], 2.49–350), mucositis (OR 11.0; 95% CI, 1.52–80.1), and malignant wounds (OR 79.5; 95% CI 1.33–4737) were significant risk factors for candidemia in HNC. Conclusions: Candidemia causes high mortality in patients with HNC. To our knowledge, malignant wounds have not been previously reported as a risk factor for candidemia. For early diagnosis and treatment of candidemia, risk factors should be considered, and antifungal therapy started earlier.
KW - Bacteremia
KW - Bloodstream infection
KW - Candidemia
KW - Head and neck cancer
KW - Malignant wounds
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U2 - 10.1007/s00520-022-07010-9
DO - 10.1007/s00520-022-07010-9
M3 - Article
C2 - 35381861
AN - SCOPUS:85127579231
SN - 0941-4355
VL - 30
SP - 5921
EP - 5930
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 7
ER -
