BACKGROUND: Candidemia caused by non-albicans Candida spp. is of special concern because of its high drug resistance and increase in prevalence. In clinical practice, early identification of non-albicans candidemia is crucial. We investigated the outcome in patients with candidemia caused by Candida albicans and Candida non-albicans. METHODS: We retrospectively evaluated candidemic patients from October 2007 to July 2009. Underlying diseases, predisposing factors, laboratory data, and outcome were analyzed. RESULTS: One hundred and eight patients of candidemia were enrolled. Candida albicans and non-albicans spp. were responsible for 56.5% (61 of 108) and 43.5% (47 of 108) of candidemia cases, respectively. Among patients with non-albicans candidemia, significantly more patients had neutropenia (p=0.001) and less patients had candiduria (p=0.001) and intensive care unit stay (p=0.002) in comparison with those with C albicans candidemia. All-cause Day 7 mortality was high in both C albicans and non-albicans spp. candidemia [44.3% (27 of 61) vs. 29.8% (14 of 47)]. Multivariate analysis revealed that poor renal function (odds ratio, 1.035; 95% confidence interval, 1.001-1.071; p=0.04) and shock (odds ratio, 19.4; 95% confidence interval, 2.53-149.5; p=0.004) are independent risk factors for fatal candidemia. CONCLUSIONS: The outcome of candidemia was poor. The identified risk factors may help us to differentiate fatal candidemia in early infection.
BACKGROUND:Candidemia caused by non-albicans Candida spp. is of special concern because of its high drug resistance and increase in prevalence. In clinical practice, early identification of non-albicans candidemia is crucial. We investigated the outcome in patients with candidemia caused by Candida albicans and Candida non-albicans. METHODS: We retrospectively evaluated candidemic patients from October 2007 to July 2009. Underlying diseases, predisposing factors, laboratory data, and outcome were analyzed. RESULTS: One hundred and eight patients of candidemia were enrolled. Candida albicans and non-albicans spp. were responsible for 56.5% (61 of 108) and 43.5% (47 of 108) of candidemia cases, respectively. Among patients with non-albicans candidemia, significantly more patients had neutropenia (p=0.001) and less patients had candiduria (p=0.001) and intensive care unit stay (p=0.002) in comparison with those with C albicans candidemia. All-cause Day 7 mortality was high in both C albicans and non-albicans spp. candidemia [44.3% (27 of 61) vs. 29.8% (14 of 47)]. Multivariate analysis revealed that poor renal function (odds ratio, 1.035; 95% confidence interval, 1.001-1.071; p=0.04) and shock (odds ratio, 19.4; 95% confidence interval, 2.53-149.5; p=0.004) are independent risk factors for fatal candidemia. CONCLUSIONS: The outcome of candidemia was poor. The identified risk factors may help us to differentiate fatal candidemia in early infection.
Authors: Anne Aittakorpi; Pentti Kuusela; Pirkko Koukila-Kähkölä; Martti Vaara; Michael Petrou; Vanya Gant; Minna Mäki Journal: J Clin Microbiol Date: 2012-09-05 Impact factor: 5.948
Authors: Matteo Bassetti; Monia Marchetti; Arunaloke Chakrabarti; Sergio Colizza; Jose Garnacho-Montero; Daniel H Kett; Patricia Munoz; Francesco Cristini; Anastasia Andoniadou; Pierluigi Viale; Giorgio Della Rocca; Emmanuel Roilides; Gabriele Sganga; Thomas J Walsh; Carlo Tascini; Mario Tumbarello; Francesco Menichetti; Elda Righi; Christian Eckmann; Claudio Viscoli; Andrew F Shorr; Olivier Leroy; George Petrikos; Francesco Giuseppe De Rosa Journal: Intensive Care Med Date: 2013-10-09 Impact factor: 17.440