Predictors of candidaemia caused by non-albicans Candida species: results of a population-based surveillance in Barcelona, Spain
Por:
Rodriguez, D, Almirante, B, Cuenca-Estrella, M, Rodriguez-Tudela, JL, Mensa, J, Ayats, J, Sanchez, F, Pahissa, A
Publicada:
1 nov 2010
Resumen:
P>Although Candida albicans (CA) is the most common cause of Candida bloodstream infections (BSIs), recent studies have observed an increasing percentage of candidaemias caused by non-albicans Candida species (NAC). In the present study, we attempted to identify the predictors of candidaemia due to NAC compared to CA. We analyzed data from an active population-based surveillance in Barcelona (Spain) from January 2002 to December 2003. Factors associated with NAC fungaemia were determined by multivariate analysis. A total of 339 episodes of Candida BSI, in 336 patients (median age 63 years, interquartile range: 41-72 years), were included. CA was the most commonly isolated (52%), followed by Candida parapsilosis (23%), Candida tropicalis (10%), Candida glabrata (8.6%), Candida krusei (3.4%) and other NAC spp. (3%).Overall, 48% of cases were due to NAC spp. Multivariate logistic regression analysis identified factors associated with a risk of BSI due to NAC spp.: having received a haematologic transplant (OR 10.8; 95% CI 1.31-90.01; p 0.027), previous fluconazole exposure (OR 4.47; 95% CI 2.12-9.43; p < 0.001) and neonatal age (OR 4.42; 95% CI 1.63-12.04; p 0.004). Conversely, previous CA colonization (OR 0.33; 95% CI 0.19-0.57; p 0.001) and previous antibiotic use (OR 0.42; 95% CI 0.21-0.85; p 0.017) were associated with CA fungaemia compared to NAC. In conclusion, NAC candidaemia comprised 48% of cases in our series. Predictors of NAC include having received a haematologic transplant, neonatal age and previous fluconazole use.
Filiaciones:
Rodriguez, D:
Univ Autonoma Barcelona, Hosp Univ Vall Hebron, Div Infect Dis, Barcelona 08035, Spain
Almirante, B:
Univ Autonoma Barcelona, Hosp Univ Vall Hebron, Div Infect Dis, Barcelona 08035, Spain
Cuenca-Estrella, M:
Inst Salud Carlos III, Dept Mycol, Madrid, Spain
Rodriguez-Tudela, JL:
Inst Salud Carlos III, Dept Mycol, Madrid, Spain
Mensa, J:
IDIBAPS, Hosp Clin, Div Infect Dis, Barcelona, Spain
Ayats, J:
Hosp Univ Bellvitge, Dept Microbiol, Barcelona, Spain
Sanchez, F:
Hosp Santa Cruz & St Pau, Dept Microbiol, Barcelona, Spain
Pahissa, A:
Univ Autonoma Barcelona, Hosp Univ Vall Hebron, Div Infect Dis, Barcelona 08035, Spain
Open Access
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