Candidemia Worsens Outcomes in Patients With Obesity
Candidemia prolongs the hospital stay of and infection duration in patients with obesity, according to new data presented at IDWeek 2018.
The report, authored by Dr Katie Barber and colleagues, will be presented on Thursday, October 4, at IDWeek 2018 in San Francisco.
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While it is well-known that obesity worsens bacterial infections, it was previously unknown how obesity affects fungal infections.
To better understand the connection, Barber and colleagues reviewed data on 80 adults diagnosed with candidemia who received more than 48 hours of antifungal therapy during their hospital stay (June 2013-December 2017).
Obesity was defined as a body mass index of 30 kg/m2 or higher.
Infection-related length of stay, time to bloodstream sterilization, and in-hospital mortality were also assessed.
Overall, 28 patients were obese and 52 were non-obese. The median age of participants was 54 years, and 55% were men.
No difference was observed in comorbidities or disease severity between groups. Source control and time to source control were similar between groups.
Obese participants consulted with infectious disease specialists more often (82.1% vs 55.8%), received quicker initiation of definitive therapy (13 hours vs 51 hours), and were more likely to receive micafungin as definitive therapy (57.1% vs 21.2%) than non-obese participants.
In-hospital mortality was higher, and infection-related and total hospital lengths of stay were longer among obese participants vs non-obese participants.
Duration of candidemia infection was longer in obese participants as well.
“Despite quicker receipt of definitive antifungal therapy, more frequent [infectious disease] consultation, and echinocandin usage, obese patients had longer duration of candidemia, increased infection-related length of stay, and numerically higher mortality,” Barber and colleagues concluded.
Barber KE, Wagner JL, Miller J, Lewis E, Stover KR. Impact of Obesity in Patients with Candida Bloodstream Infections. Paper presented at: IDWeek 2018; October 3-7, 2018; San Francisco, CA. https://idsa.confex.com/idsa/2018/webprogram/Paper70482.html. Accessed October 2, 2018.