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Volume 46, Number 6, December 2013

Associated clinical characteristics of patients with candidemia among different Candida species 


Liang-Yu Chen, Shu-Chen Kuo, Hau-Shin Wu, Su-Pen Yang, Yu-Jiun Chan, Liang-Kung Chen, Fu-Der Wang


Received: March 4, 2012    Revised: July 1, 2012    Accepted: July 30, 2012   

 

Corresponding author:

Fu-Der Wang, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Corresponding Author InformationCorresponding author. Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan. 



 

Background and purpose: 

The rising incidence of non-albicans Candida (NAC) infection has been associated with a potentially adverse outcome for patients with candidemia. However, categorizing various species causing candidemia into a single NAC group might lead to inappropriate conclusions due to heterogeneity in species. Thus we examined the associated factors among patients with candidemia caused by different species. 



 

Methods:

This retrospective study was conducted at a tertiary medical center in Taiwan from 2006 to 2009. Mortality rate, demographic and clinical characteristics, albumin levels, and severity scores of acute illness of patients at the onset of candidemia were analyzed. 



 

Results:

A total of 447 episodes among 418 patients were included for analysis. The overall 30-day crude mortality was 48.2%, with no significant difference between C. albicans and NAC candidemia, but apparently C. parapsilosis candidemia was associated with a lower mortality rate. Time to positivity for yeast was significantly different between species. Compared with infection involving C. albicans, more frequent use of total parenteral nutrition, lower Sequential Organ Failure Assessment score and higher albumin levels were observed for C. parapsilosis candidemia. 



 

Conclusion:

Identifying associated factors for each species may be a more effective approach than single NAC grouping. Time to positivity may be a hint for treatment guidance in candidemia. More frequent use of total parenteral nutrition and less virulent nature were noted for C. parapsilosis candidemia. 



 

Key words:

Candidemia, Non-albicans Candida species, Time to positivity, Total parenteral nutrition