Treatment of catheter-related candidemia

Candidemia is a major cause of morbidity and mortality, and is frequently associated with primary or secondary intravascutar catheter-related infection. A diagnosis of intravascular catheter-related candidemia is difficult before removing the catheter as much as this procedure is usually considered to be a standard practice associated with systemic antifungal therapy. Moreover, biofilm production by Candida contributes to increase adherence to the surface of material and decrease susceptibility to antifungal agents. However, conservative strategy of the catheter in candidemia, including local type "antibiotic lock" and systemic antifungat therapy, could be adopted in clinically stable patients for whom intravascutar catheter replacement is perilous. (c) 2006 Elsevier Masson SAS. Tous droits reserves.