Clinical characteristics and risk factors for mortality in adult patients with persistent candidemia

Abstract

We investigated the clinical characteristics and risk factors for mortality in adults with persistent candidemia. All patients ≥18 years old with candidemia in two Korean tertiary hospitals from 2007 to 2014 were investigated. Persistent candidemia was defined as isolation of the same Candida species ≥5 days after initiation of antifungal therapy. Non-persistent candidemia was defined as candidemia persisting for ≤3 days after initiation of antifungal therapy. Candida tropicalis (29.2%) was the most common pathogen in persistent candidemia, and Candida albicans (35.9%) was the most common in non-persistent candidemia. Central venous catheter (CVC) (OR, 1.99; 95% CI, 1.05-3.78; P=0.034), longer hospital stay (OR 1.01; 95% CI, 1.01-1.02; P=0.025), and severe sepsis (OR 2.25; 95% CI, 1.11-4.56; P=0.024) were independent risk factors for persistent candidemia. C. tropicalis was independently related to 30-day mortality (OR, 4.12; 95% CI, 1.27-13.36; P=0.018), together with septic shock (OR, 5.81; 95% CI, 1.32-24.70; P=0.017) and use of a corticosteroids (OR, 5.31; 95% CI, 1.07-26.29; P=0.041) in persistent candidemia. C. tropicalis is the predominant pathogen and cause of death in patients with persistent candidemia.