Blood stream infections by Candida glabrata and Candida krusei: A single-center experience

Kyoung Choi Hee, Jin Jeong Su, Sung Lee Han, Sik Chin Bum, Hoon Choi Suk, Hoon Han Sang, Soo Kim Myung, Oh Kim Chang, Yong Choi Jun, Goo Song Young, Myung Kim June

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Abstract

Background/Aims: The increasing incidence of Candida glabrata and Candida krusei infections is a significant problem because they are generally more resistant to fluconazole. We compared the risk factors associated with C. glabrata and C. krusei fungemia with Candida albicans fungemia and examined the clinical manifestations and prognostic factors associated with candidemia. Methods: We retrospectively reviewed demographic data, risk factors, clinical manifestations, and outcomes associated with C. glabrata and C. krusei fungemia at a tertiary-care teaching hospital during a 10-years period from 1997 to 2006. Results: During the study period, there were 497 fungemia episodes. C. glabrata fungemia accounted for 23 episodes and C. krusei fungemia accounted for 8. Complete medical records were available for 27 of these episodes and form the basis of this study. Compared to 54 episodes of C. albicans fungemia, renal insufficiency and prior fluconazole prophylaxis were associated with development of C. glabrata or C. krusei fungemia. The overall mortality was 67%. The fungemia-related mortality of C. glabrata and C. krusei was higher than that of C. albicans (52 vs. 26%, p=0.021). Empirical antifungal therapy did not decrease the crude mortality. Multiple logistic regression analysis showed that high APACHE II scores, catheter maintenance, and shock were independently associated with an increased risk of death. Conclusions: Renal insufficiency and prior fluconazole prophylaxis were associated with the development of C. glabrata or C. krusei fungemia. Fungemia-related mortality of C. glabrata or C. krusei was higher than that of C. albicans. Outcomes appeared to be related to catheter removal, APACHE II scores, and shock.

Original languageEnglish
Pages (from-to)263-269
Number of pages7
JournalKorean Journal of Internal Medicine
Volume24
Issue number3
DOIs
Publication statusPublished - 2009 Dec 21

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All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Hee, K. C., Su, J. J., Han, S. L., Bum, S. C., Suk, H. C., Sang, H. H., Myung, S. K., Chang, O. K., Jun, Y. C., Young, G. S., & June, M. K. (2009). Blood stream infections by Candida glabrata and Candida krusei: A single-center experience. Korean Journal of Internal Medicine, 24(3), 263-269. https://doi.org/10.3904/kjim.2009.24.3.263