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J Microbiol Immunol Infect. 2011 Oct;44(5):369-75. doi: 10.1016/j.jmii.2010.08.010. Epub 2011 Jan 20.

Candida albicans versus non-albicans bloodstream infections: the comparison of risk factors and outcome.

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1
Department of Internal Medicine, Song-Shan Armed Forces General Hospital, Taipei, Taiwan.

Abstract

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.

Comment in

PMID:
21524971
DOI:
10.1016/j.jmii.2010.08.010
[Indexed for MEDLINE]
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