Abstract
Many uncommon Candida species that cause bloodstream infections (BSIs) are not well-characterized. We investigated the epidemiology, antifungal use, susceptibility patterns, and factors associated with all-cause death among cancer patients in whom uncommon Candida spp. BSIs were diagnosed at a cancer treatment center during January 1998–September 2013. Of 1,395 Candida bloodstream isolates, 79 from 68 patients were uncommon Candida spp. The incidence density of uncommon Candida spp. BSIs and their proportion to all candidemia episodes substantively increased during the study period, and the rise was associated with increasing use of echinocandin antifungal drugs. Thirty-seven patients had breakthrough infections during therapy or prophylaxis with various systemic antifungal drugs for >7 consecutive days; 21 were receiving an echinocandin. C. kefyr (82%), and C. lusitaniae (21%) isolates frequently showed caspofungin MICs above the epidemiologic cutoff values. These findings support the need for institutional surveillance for uncommon Candida spp. among cancer patients.
Highlights
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medscape, LLC and Emerging Infectious Diseases
We evaluated the epidemiologic characteristics, susceptibility patterns, and factors associated with all-cause death among cancer patients who had uncommon Candida spp
A total of 79 episodes of illness among 68 patients were caused by 5 uncommon Candida spp.: C. guilliermondii (n = 28, 41%), C. lusitaniae (n = 19, 28%), C. kefyr (n = 13, 19%), C. famata (n = 7, 10%), and C. dublinensis (n = 1, 1%)
Summary
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medscape, LLC and Emerging Infectious Diseases. LLC is accredited by the ACCME to provide continuing medical education for physicians. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: [1] review the learning objectives and author disclosures; [2] study the education content; [3] take the post-test with a 75% minimum passing score and complete the evaluation at http://www.medscape.org/journal/eid; [4] view/print certificate. CME Editor Jean Michaels Jones, Technical Writer/Editor, Emerging Infectious Diseases. Disclosure: Jean Michaels Jones has disclosed no relevant financial relationships
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