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Clinical manifestations and molecular epidemiology of late recurrent candidemia, and implications for management.

Abstract
The aim of this study was to define the epidemiology and clinical manifestations of late recurrent candidemia. For this purpose, late recurrent candidemia was defined as an episode of candidemia occurring at least 1 month after the apparent complete resolution of an infectious episode caused by the same Candida sp. A total of five patients with recurrent candidemia were investigated. For all patients, isolates from the initial and recurrent episodes of candidemia were available for in vitro susceptibility testing and genetic characterization by DNA-based techniques. The results revealed the following salient features: prolonged duration between the initial and recurrent episodes (range, 1-8 months); recurrence of candidemia despite anti-fungal therapy; importance of retained intravascular catheters, neutropenia, and corticosteroids as factors predisposing to recurrence; high morbidity and mortality; no emergence of antifungal drug resistance between the initial and recurrent episodes; and relapse of infection due to the original infecting strain, rather than reinfection with a new strain. These findings raise several issues about the management and follow-up of patients with candidemia, which require assessment in future studies.
AuthorsC J Clancy, F Barchiesi, L Falconi DiFrancesco, A J Morris, D R Snydman, V L Yu, G Scalise, M H Nguyen
JournalEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology (Eur J Clin Microbiol Infect Dis) Vol. 19 Issue 8 Pg. 585-92 (Aug 2000) ISSN: 0934-9723 [Print] Germany
PMID11014620 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antifungal Agents
  • DNA, Fungal
Topics
  • Aged
  • Antifungal Agents (pharmacology, therapeutic use)
  • Candida (classification, drug effects, genetics, isolation & purification)
  • Candidiasis (drug therapy, epidemiology, microbiology)
  • DNA, Fungal (analysis)
  • Female
  • Fungemia (drug therapy, epidemiology, microbiology)
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Molecular Epidemiology
  • Polymerase Chain Reaction (methods)
  • Recurrence

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