Abstract
Candidemia is a growing concern worldwide, and its species distribution has shifted toward non-albicans Candida in recent decades, especially in patients with malignancy. This study aimed to update the epidemiology and antifungal susceptibility of non-albicans candidemia isolates from the cancer patients. Adult cancer patients with non-albicans candidemia were recruited, and clinical data were retrospectively collected from five medical centers in Taiwan from 1 July 2011 to 30 June 2014. In vitro susceptibility was determined by the broth dilution method using a Sensititre YeastOne system and interpreted according to the guidelines of the Clinical and Laboratory Standards Institute. A total of 346 episodes of non-albicans candidemia were identified in cancer patients. Candida tropicalis was the most common species (n=145, 41.9%) and had the highest resistance rate to fluconazole (n=17, 13.9%) among all the preserved isolates, including C. tropicalis, Candida glabrata and Candida parapsilosis. A higher Charlson comorbidity index, non-albicans candidemia due to C. tropicalis, neutropenia and septic shock were independent predictors of 28-day mortality. In conclusion, the species distribution and antifungal susceptibility of non-albicans candidemia isolates in our study differed from those in Western countries, providing useful information about local epidemiology for the selection of empirical antifungal agents for cancer patients.
Highlights
Candida species have become increasingly important pathogens in healthcare settings worldwide
The medical records of all enrolled patients were reviewed by infectious disease specialists, and the variables collected from medical charts were as follows: age, gender, Charlson comorbidity index, underlying comorbidities, cancer types, origin of non-albicans candidemia, underlying conditions, severity of illness, concomitant bacterial infections, antifungal therapy and 28-day outcome
We report several relevant findings obtained from a large multicenter study that characterized non-albicans candidemia in cancer patients
Summary
Candida species have become increasingly important pathogens in healthcare settings worldwide. In 2004, candidemia was reported as the fourth to sixth leading cause of nosocomial bloodstream infections in Western countries, including in the United States and Switzerland.[1,2] A more recent multicenter study in 2014 that enrolled 183 hospitals in the United States showed that candidemia was the most common etiology of healthcare-associated bloodstream infections.[3] In Taiwan, the incidence of candidemia has shown an increasing trend, from 0.8 patients per 10 000 discharges in 1981 to 28.8 patients per 10 000 discharges in 2000.4 the species distribution of candidemia varies geographically and has changed in recent decades. We conducted a multicenter study to determine the clinical characteristics and antifungal susceptibilities of non-albicans
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
