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These difficulties in establishing a prompt diagnosis have also influenced discussion in the literature regarding the clinical benefit of early removal [20]. Therefore, clinicians must carefully consider the indication for catheter withdrawal, especially in the case of tunneled CVCs that require a surgical procedure for replacement [21-24]. There are some circumstances Ribociclib that may suggest the involvement of the catheter, such as evidence of suppurative phlebitis in a patient with candidaemia or isolation of C. parapsilosis in an adult patient, but not in a paediatric patient, as our data have proven [25, 26]. However, in many instances, the origin of the fungaemia is not clinically evident, and there is a clear lack of microbiological techniques for reliably identifying Candida-infected catheters without the need for withdrawal. While laboratory microbiological procedures (e.g. differential colony counts, DTTP, or superficial culture) have proven effective in catheter-related bacteraemia, they have not been sufficiently tested in candidaemia [4, 6-10]. Some authors Otenabant attempted to diagnose C-RC with the catheter in situ. Telenti et?al. [27] found a good association between intravascular device infection and high-grade candidaemia (��25?cfu/10?mL in peripheral blood specimens). In their prospective study of Candida bloodstream infections, Ben-Ami et?al. [12] observed that an MTTP of peripheral blood of >30?h ruled out the CVC as the source of candidaemia (100% sensitivity and 51.4% specificity for C-RC). Although we also found MTTP to be significantly shorter in adults with catheter-related candidaemia (29.8?h vs. 36.8?h, p?Selleckchem MI-773 specificity, 60.7%; positive predictive value, 71.8%; negative predictive value, 37.8%. We found the best cut-off of MTTP for the prediction of C-RC in adults to be