Comparison of the clinical risk factors between Candida albicans and Candida non-albicans species for bloodstream infection.

Abstract

The purpose of this study is to investigate the risk factors and susceptibilities to antifungal agents of Candida albicans and Candida non-albicans species (spp.) in candidemia cases in Kobe University Hospital. We investigated all consecutive patients with candida bloodstream infection (BSI) from 2008-2013 for whose full data were available for analyses, examining clinical factors such as gender, general complications, postoperative status or susceptibilities to antifungal agents. These factors were also compared between Candida albicans spp. and Candida non-albicans by univariate and multivariate analyses. Univariate analyses showed a significantly higher rate of Candida non-albicans species BSI patients cancer (odds ratio (OR) (95% confidence interval (CI))=2.29 (1.04-5.06) and P=0.040), chemotherapy (OR=4.35 (1.11-17.1) and P=0.035), fluconazole (FLCZ) resistance (OR=77.3 (4.51-1324) and P=0.003), and itraconazole (ITCZ) resistance (OR=15.6 (5.39-45.1) and P<0.001) and lower rate of underlying cardiovascular diseases (OR=0.27 (0.09-0.80) and P=0.018) and postoperative status (OR=0.35 (0.16-0.77) and P=0.035) in than Candida albicans. Multivariate analyses demonstrated that Candida non-albicans spp. had significantly higher rate of chemotherapy (OR=4.44 (1.04-19.0) and P=0.045), FLCZ resistance (OR=5.87 (2.01-17.1) and P=0.001), and ITCZ resistance (OR=18.7(5.77-60.4) and P<0.001) and lower rate of underlying cardiovascular diseases (OR=0.25 (0.08-0.82) and P=0.022) than Candida albicans. In conclusion, this study revealed several risk factors for BSI with Candida albicans (underlying cardiovascular diseases and postoperative status) and Candida non-albicans spp. (cancer and chemotherapy), and demonstrated that Candida non-albicans spp. were more resistant to FLCZ and ITCZ than Candida albicans.

• Authors: Katsumi Shigemura, Kayo Osawa, Takumi Jikimoto, Hiroyuki Yoshida, Brian Hayama, Goh Ohji, Kentaro Iwata, Masato Fujisawa, Soichi Arakawa
• Journal: The Journal of antibiotics (J Antibiot (Tokyo)) Vol. 67 Issue 4 Pg. 311-4 (Apr 2014) ISSN: 1881-1469 [Electronic] England
• PMID: 24424346 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Antifungal Agents
• Antineoplastic Agents
• Itraconazole
• Fluconazole

Topics

• Aged
• Aged, 80 and over
• Antifungal Agents (pharmacology, therapeutic use)
• Antineoplastic Agents (adverse effects, therapeutic use)
• Candida (drug effects, growth & development, isolation & purification)
• Candida albicans (drug effects, growth & development, isolation & purification)
• Candidemia (complications, drug therapy, epidemiology, microbiology)
• Cardiovascular Diseases (complications, surgery)
• Drug Resistance, Fungal
• Female
• Fluconazole (pharmacology, therapeutic use)
• Hospitals, University
• Hospitals, Urban
• Humans
• Itraconazole (pharmacology, therapeutic use)
• Japan (epidemiology)
• Male
• Microbial Sensitivity Tests
• Middle Aged
• Neoplasms (complications, drug therapy)
• Retrospective Studies
• Risk Factors