Clinical characteristics and risk factors of non-Candida fungaemia

BMC Infectious Diseases

Satoshi Ichiyama²  Yutaka Ito¹  Miki Nagao²  Aki Matsushima²  Yasufumi Matsumura²  Gou Hotta²  Shunji Takakura²  Masaki Yamamoto² 

[1] Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan;Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 6068507, Japan

关键词: Colonisation;    Mortality;    Risk factor;    Non-Candida yeast;    Fungaemia;   

Others  :  1148070
DOI  :  10.1186/1471-2334-13-247

 received in 2012-09-06, accepted in 2013-05-15,  发布年份 2013

【 摘 要 】

Background

The incidence of fungaemia has been increasing worldwide. It is important to distinguish non-Candida fungaemia from candidaemia because of their different antifungal susceptibilities. The aims of this study were to investigate the clinical characteristics of non-Candida fungaemia and identify the clinical factors that differentiate it from candidaemia.

Methods

We investigated the clinical manifestations and mortality of non-Candida fungaemia in Kyoto University Hospital from 2004 to 2009.

Results

There were 110 episodes of fungaemia during the study period. There were 11 renal replacement therapy episodes of fungaemia due to non-Candida yeasts (10.0%), including 6 episodes with Cryptococcus neoformans, 4 with Trichosporon asahii, and 1 with Kodamaea ohmeri, in addition to 99 episodes of candidaemia (90.0%). The presence of collagen disease [odds ratio (OR) 9.00; 95% confidence interval (CI) 1.58-51.4; P = 0.01] or renal replacement therapy (OR 15.0; 95% CI 3.06-73.4; P < 0.01) was significantly more common in non-Candida fungaemia patients than in candidaemia patients. Prior colonisation by the species may be a predictor of non-Candida fungaemia. Non-Candida fungaemia had a higher mortality than candidaemia (54.5% versus 21.2%, P = 0.03).

Conclusions

Although Candida species frequently cause fungaemia, we should also be aware of non-Candida yeasts because of their high mortality, particularly among high-risk patients, such as those with collagen disease and those under renal replacement therapy. Prior colonisation by the causative organisms may be an important predictor of non-Candida fungaemia.

【 授权许可】

   
2013 Yamamoto et al.; licensee BioMed Central Ltd.

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