Clinical significance of Candida colonization of central vascular catheters in patients with major burns requiring intensive care

Dear Editor, Patients with thermal injury are vulnerable to local and systemic infections. Candida spp. were the second most common pathogens isolated from catheter tips in European countries (9.1 %) [1]. Although several studies were performed to evaluate the clinical relevance of Candida spp. colonization of intravascular catheters, burn patients were only rarely studied [2–5]. Patients suffering from severe burns with an Abbreviated Burn Severity Index (ABSI) C6, a length of ICU stay C24 h, a survival of more than 7 days and central venous catheter (CVC) tip culture yielding C15 colony-forming units of Candida spp. met the general inclusion criteria for this study. Patients were categorized into two groups based on their final outcome. Group I consisted of subjects with ‘‘poor outcome’’ (patients with positive CVC tip cultures for Candida spp. that suffered from subsequent or catheter related candidemia); Group II consisted of subjects with ‘‘good outcome’’ (patients with positive CVC tip cultures for Candida spp. that did not suffer from subsequent or catheter-related candidemia) (Table 1). Candidemia was defined as the presence of at least one positive blood culture for any Candida spp. Catheter-related candidemia was defined as detection of the same Candida sp. from the CVC tip and blood culture, obtained 48 h before to 48 h after CVC removal. Subsequent candidemia was defined as the occurrence of candidemia C48 h after CVC removal. Tip cultures, screening for fungal or bacterial pathogens, are always performed when a CVC is removed. A total of 38/194 (20 %) patients met the inclusion criteria for the present study (Table 1). Of these,