Factors related to outcome of bloodstream infections due to Candida parapsilosis complex. Issue 1 (December 2016)

• Record Type: Journal Article
• Authors: Barchiesi, Francesco; Orsetti, Elena; Osimani, Patrizia; Catassi, Carlo; Santelli, Fabio; Manso, Esther
• Is Part Of: BMC infectious diseases. Volume 16:Issue 1(2016)
• Page Start: 1
• Page End: 7
• Publication Date: 2016-12
• Subjects: Candida paraspilosis complex -- Candidemia -- Risk factors -- Mortality -- Antifungal agents; Communicable diseases -- Periodicals; Sexually Transmitted Diseases -- Periodicals; 616.905
• DOI: 10.1186/s12879-016-1704-y
• Languages: English
• ISSNs: 1471-2334

Abstract

Abstract Background AlthoughCandida albicans is the most common cause of fungal blood stream infections (BSIs), infections due toCandida species other thanC. albicans are rising.Candida parapsilosis complex has emerged as an important fungal pathogen and became one of the main causes of fungemia in specific geographical areas. We analyzed the factors related to outcome of candidemia due toC. parapsilosis in a single tertiary referral hospital over a five-year period. Methods A retrospective observational study of all cases of candidemia was carried out at a 980-bedded University Hospital in Italy. Data regarding demographic characteristics and clinical risk factors were collected from the patient's medical records. Antifungal susceptibility testing was performed and MIC results were interpreted according to CLSI species-specific clinical breakpoints. Results Of 270 patients diagnosed withCandida BSIs during the study period, 63 (23 %) were infected with isolates ofC. parapsilosis complex which represented the second most frequently isolated yeast afterC. albicans . The overall incidence rate was 0.4 episodes/1000 hospital admissions. All the strains were in vitro susceptible to all antifungal agents. The overall crude mortality at 30 days was 27 % (17/63), which was significantly lower than that reported forC. albicans BSIs (42 % [61/146], p = 0.042). Being hospitalized in ICU resulted independently associated with a significant higher risk of mortality (HR 4.625 [CI95% 1.015–21.080], p = 0.048). Conversely, early CVC removal was confirmed to be significantly associated with a lower risk of mortality (HR 0.299 [CI95% 0.102–0.874], p = 0.027). Finally, the type of primary antifungal therapy did not influence the outcome of infection. Conclusions Candidemia due toC. parapsilosis complex, the second most commonly causative agent of yeast BSIs in our center, is characterized by a non-negligible mortality at 30 days. An early CVC removal is associated with a significant reduced mortality.