Evaluation of species distribution and risk factors of candidemia: A multicenter case-control study


Yapar N., Pullukcu H., Avkan-Oguz V., Sayin-Kutlu S., Ertugrul B., Sacar S., ...More

MEDICAL MYCOLOGY, vol.49, no.1, pp.26-31, 2011 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 49 Issue: 1
  • Publication Date: 2011
  • Doi Number: 10.3109/13693786.2010.501344
  • Journal Name: MEDICAL MYCOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.26-31
  • Keywords: Candidemia, C. albicans, non-Candida albicans Candida species, risk factors, INVASIVE FUNGAL DISEASE, BLOOD-STREAM INFECTIONS, EPIDEMIOLOGY, CANDIDIASIS, CANDIDAEMIA, PREDICTORS, ALBICANS, EUROPE
  • Dokuz Eylül University Affiliated: Yes

Abstract

This study was planned to determine the risk factors of candidemia, and the most common Candida species causing bloodstream infections. A case-control study which included adult patients was conducted over a 1-year period at tertiary-care educational hospitals in Turkey. A total of 83 candidemia episodes were identified during the study period. Candida albicans was the most common species recovered (45.8%) followed by Candida tropicalis (24.1%) Candida parapsilosis (14.5%) and Candida glabrata which was isolated from only four (4.8%) patients. Presence of a urethral catheter (odds ratio [OR] 2.38; 95% confidence interval [CI] 1.09-5.19; P = 0.02), previous use of antibiotics (OR 2.61; 95% CI 1.05-6.46; P = 0.03), RBC transfusions (OR 2.14; 95% CI 1.16-3.94; P = 0.01) and parenteral nutrition (OR 4.44; 95% CI 2.43-8.11; P < 0.01) were found as independent risk factors for candidemia. TPN (Total Parenteral Nutrition) was an independent risk factor for both C. albicans and non-Candida albicans Candida species (P < 0.001). Most of the risk factors were invasive procedures and former medications. We conclude that a great number of candidemia cases are preventable by means of reduction of unnecessary invasive procedures and the use of antimicrobials.