Body weight does not contribute to death in candidemia

Body mass index (BMI) appears to have no influence over mortality among patients with candidemia, suggests a recent study.

In this retrospective cohort study, the authors sought to determine the link between BMI and clinical outcomes of candidemia patients on standard doses of anidulafungin and characterize fungal infections by body weight. Participants on anidulafungin were treated for at least 3 days from 1 January 2014 through 31 January 2018.

Candidemia was diagnosed through blood culture or T2 magnetic resonance. The authors then compared patients according to BMI category.

Of the 173 patients included, 58 (33 percent) were diagnosed with Candida albicans and 57 (33 percent) with Candida glabrata.

There was no significant difference in mortality rates across BMI categories: four (36.4 percent) underweight, eight (25.8 percent) normal weight, 16 (32.0 percent) overweight, 20 (33.9 percent) obese, and seven (31.8 percent) morbidly obese (p=0.976).

Severe sepsis (adjusted odds ratio [aOR], 5.1, 95 percent confidence interval [CI], 1.7‒14.8) and liver disease (aOR, 3.2, 95 percent CI, 1.1‒9.4) were associated with higher mortality. On the other hand, line removal (aOR, 0.05, 95 percent CI, 0.02‒0.2) and receipt of anidulafungin for at least 5 days (aOR, 0.35, 95 percent CI, 0.15‒0.8) correlated with a lower risk of mortality.

“Larger studies are needed to confirm whether standard doses of anidulafungin are sufficient for candidemia in obese patients,” the authors said.