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Volume 44, Number 5, October 2011

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


Hung-Wei Chi, Ya-Sung Yang, Shi-Ta Shang, Ke-Hung Chen, Kuo-Ming Yeh, Feng-Yee Chang, Jung-Chung Lin


Received: January 5, 2010    Revised: July 14, 2010    Accepted: August 26, 2010   

 

Corresponding author:

Jung-Chung Lin, Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan



 

Background and purpose: 

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.



 

Conclusion:

The outcome of candidemia was poor. The identified risk factors may help us to differentiate fatal candidemia in early infection.



 

Key words:

Candida albicans, Candidemia, Non-albicans