Epidemiology, risk factors, and outcomes of Candida albicans versus non-albicans candidemia in nonneutropenic patients

Susan L. Davis, Jose Antonio Vazquez, Peggy S. McKinnon

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Candidemia is a major cause of morbidity and mortality In hospitalized patients. OBJECTIVES: To describe the epidemiology of and risk factors for non-albicans candidemia (NAC) in nonneutropenic adults and the impact of NAC on patient outcomes and treatment cost. METHODS: We conducted a retrospective cohort analysis comparing demographics and risk factors for Candida albicans candidemia (CAC) versus NAC in 144 non-neutropenic patients with candidemia over a 6 year period (1997-2002) at Detroit Receiving Hospital. RESULTS: Candida species distribution included albicans (50%), parapsilosis (13%), tropicalis (10%), and glabrata (13%). Predominant species varied by patient care unit, with C. glabrata more common in the medical intensive care unit (ICU) and C. parapsilosis in the burn ICU. In multivariate analysis, NAC was associated with the absence of antibiotic use at the onset of candidemia, recent history of solid tumor, and mate sex. NAC was not associated with an increase in mortality or length of stay compared with CAC, but was found to have a higher cost of antifungal therapy ($2030 vs $780; p = 0.05). CONCLUSIONS: The epidemiology of candidemia is complex and varies among the different patient care units. Specifically, patients appear less likety to develop NAC if they are receiving antibiotics at the onset of candidemia. Increased awareness of risk factors for NAC can be used to guide adequate initial antifungal therapy.

Original languageEnglish (US)
Pages (from-to)568-573
Number of pages6
JournalAnnals of Pharmacotherapy
Volume41
Issue number4
DOIs
StatePublished - Apr 1 2007

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Candidemia
Candida albicans
Epidemiology
Intensive Care Units
Patient Care
Anti-Bacterial Agents
Mortality
Candida

Keywords

  • Candida albicans
  • Non-albicans

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Epidemiology, risk factors, and outcomes of Candida albicans versus non-albicans candidemia in nonneutropenic patients. / Davis, Susan L.; Vazquez, Jose Antonio; McKinnon, Peggy S.

In: Annals of Pharmacotherapy, Vol. 41, No. 4, 01.04.2007, p. 568-573.

Research output: Contribution to journalArticle

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AB - BACKGROUND: Candidemia is a major cause of morbidity and mortality In hospitalized patients. OBJECTIVES: To describe the epidemiology of and risk factors for non-albicans candidemia (NAC) in nonneutropenic adults and the impact of NAC on patient outcomes and treatment cost. METHODS: We conducted a retrospective cohort analysis comparing demographics and risk factors for Candida albicans candidemia (CAC) versus NAC in 144 non-neutropenic patients with candidemia over a 6 year period (1997-2002) at Detroit Receiving Hospital. RESULTS: Candida species distribution included albicans (50%), parapsilosis (13%), tropicalis (10%), and glabrata (13%). Predominant species varied by patient care unit, with C. glabrata more common in the medical intensive care unit (ICU) and C. parapsilosis in the burn ICU. In multivariate analysis, NAC was associated with the absence of antibiotic use at the onset of candidemia, recent history of solid tumor, and mate sex. NAC was not associated with an increase in mortality or length of stay compared with CAC, but was found to have a higher cost of antifungal therapy ($2030 vs $780; p = 0.05). CONCLUSIONS: The epidemiology of candidemia is complex and varies among the different patient care units. Specifically, patients appear less likety to develop NAC if they are receiving antibiotics at the onset of candidemia. Increased awareness of risk factors for NAC can be used to guide adequate initial antifungal therapy.

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