Risk factors and prognosis for persistent candidemia without catheter colonization

Yun Tae Chae, Su Jin Jeong, Nam Su Ku, Ji Hyeon Baek, Hyewon Kim, Sun Bean Kim, Ji Hyun Yoon, Sung Joon Jin, Sang Hoon Han, Young Goo Song, June Myung Kim, Jun Yong Choi

Research output: Contribution to journalArticle

Abstract

Background: Candidemia is one of the most common causes of nosocomial bloodstream infection, and increases the morbidity and mortality rate of seriously ill patients. We evaluated the risk factors and outcomes associated with persistent candidemia without catheter colonization (non-catheter related candidemia) and compared them with those of non-persistent candidemia. Materials and Methods: A retrospective case-control study was performed to identify risk factors for, and outcomes of, persistent candidemia. All adults who experienced candidemia in a university-affiliated hospital in Korea between January 2005 and December 2009 were included. Patients with catheter colonization were excluded. Persistent candidemia was defined as the occurrence of candidemia in a patient receiving at least 3 days of systemic antifungal agents prior to the second positive blood culture. Results: Of 605 adult patients with candidemia, 104 (17.2%) patients had persistent candidemia and 23 (3.8%) patients were free of catheter colonization. There were no statistically significant differences in baseline characteristics between patients with persistent and non-persistent candidemia. In univariate analysis, less use of metronidazole, glycopeptide, fluoroquinolone, and aminoglycoside, and presence of Candida parapsilosis were significantly associated with persistent candidemia. In multivariate analysis, less use of metronidazole was an independent factor associated with persistent candidemia. The candidemia related mortality was insignificantly (P =0.094) higher in persistent candidemia than non-persistent candidemia. Conclusions: Persistent candidemia can occur without catheterization. Patterns of antibiotic use could be associated with the occurrence of persistent candidemia, and prognosis of persistent candidemia seems to be worse than non-persistent candidemia. Further studies for persistent candidemia should be performed.

Original languageEnglish
Pages (from-to)349-354
Number of pages6
JournalInfection and Chemotherapy
Volume43
Issue number4
DOIs
Publication statusPublished - 2011 Aug 1

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Candidemia
Catheters
Metronidazole

All Science Journal Classification (ASJC) codes

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Chae, Yun Tae ; Jeong, Su Jin ; Ku, Nam Su ; Baek, Ji Hyeon ; Kim, Hyewon ; Kim, Sun Bean ; Yoon, Ji Hyun ; Jin, Sung Joon ; Han, Sang Hoon ; Song, Young Goo ; Kim, June Myung ; Choi, Jun Yong. / Risk factors and prognosis for persistent candidemia without catheter colonization. In: Infection and Chemotherapy. 2011 ; Vol. 43, No. 4. pp. 349-354.
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title = "Risk factors and prognosis for persistent candidemia without catheter colonization",
abstract = "Background: Candidemia is one of the most common causes of nosocomial bloodstream infection, and increases the morbidity and mortality rate of seriously ill patients. We evaluated the risk factors and outcomes associated with persistent candidemia without catheter colonization (non-catheter related candidemia) and compared them with those of non-persistent candidemia. Materials and Methods: A retrospective case-control study was performed to identify risk factors for, and outcomes of, persistent candidemia. All adults who experienced candidemia in a university-affiliated hospital in Korea between January 2005 and December 2009 were included. Patients with catheter colonization were excluded. Persistent candidemia was defined as the occurrence of candidemia in a patient receiving at least 3 days of systemic antifungal agents prior to the second positive blood culture. Results: Of 605 adult patients with candidemia, 104 (17.2{\%}) patients had persistent candidemia and 23 (3.8{\%}) patients were free of catheter colonization. There were no statistically significant differences in baseline characteristics between patients with persistent and non-persistent candidemia. In univariate analysis, less use of metronidazole, glycopeptide, fluoroquinolone, and aminoglycoside, and presence of Candida parapsilosis were significantly associated with persistent candidemia. In multivariate analysis, less use of metronidazole was an independent factor associated with persistent candidemia. The candidemia related mortality was insignificantly (P =0.094) higher in persistent candidemia than non-persistent candidemia. Conclusions: Persistent candidemia can occur without catheterization. Patterns of antibiotic use could be associated with the occurrence of persistent candidemia, and prognosis of persistent candidemia seems to be worse than non-persistent candidemia. Further studies for persistent candidemia should be performed.",
author = "Chae, {Yun Tae} and Jeong, {Su Jin} and Ku, {Nam Su} and Baek, {Ji Hyeon} and Hyewon Kim and Kim, {Sun Bean} and Yoon, {Ji Hyun} and Jin, {Sung Joon} and Han, {Sang Hoon} and Song, {Young Goo} and Kim, {June Myung} and Choi, {Jun Yong}",
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Chae, YT, Jeong, SJ, Ku, NS, Baek, JH, Kim, H, Kim, SB, Yoon, JH, Jin, SJ, Han, SH, Song, YG, Kim, JM & Choi, JY 2011, 'Risk factors and prognosis for persistent candidemia without catheter colonization', Infection and Chemotherapy, vol. 43, no. 4, pp. 349-354. https://doi.org/10.3947/ic.2011.43.4.349

Risk factors and prognosis for persistent candidemia without catheter colonization. / Chae, Yun Tae; Jeong, Su Jin; Ku, Nam Su; Baek, Ji Hyeon; Kim, Hyewon; Kim, Sun Bean; Yoon, Ji Hyun; Jin, Sung Joon; Han, Sang Hoon; Song, Young Goo; Kim, June Myung; Choi, Jun Yong.

In: Infection and Chemotherapy, Vol. 43, No. 4, 01.08.2011, p. 349-354.

Research output: Contribution to journalArticle

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T1 - Risk factors and prognosis for persistent candidemia without catheter colonization

AU - Chae, Yun Tae

AU - Jeong, Su Jin

AU - Ku, Nam Su

AU - Baek, Ji Hyeon

AU - Kim, Hyewon

AU - Kim, Sun Bean

AU - Yoon, Ji Hyun

AU - Jin, Sung Joon

AU - Han, Sang Hoon

AU - Song, Young Goo

AU - Kim, June Myung

AU - Choi, Jun Yong

PY - 2011/8/1

Y1 - 2011/8/1

N2 - Background: Candidemia is one of the most common causes of nosocomial bloodstream infection, and increases the morbidity and mortality rate of seriously ill patients. We evaluated the risk factors and outcomes associated with persistent candidemia without catheter colonization (non-catheter related candidemia) and compared them with those of non-persistent candidemia. Materials and Methods: A retrospective case-control study was performed to identify risk factors for, and outcomes of, persistent candidemia. All adults who experienced candidemia in a university-affiliated hospital in Korea between January 2005 and December 2009 were included. Patients with catheter colonization were excluded. Persistent candidemia was defined as the occurrence of candidemia in a patient receiving at least 3 days of systemic antifungal agents prior to the second positive blood culture. Results: Of 605 adult patients with candidemia, 104 (17.2%) patients had persistent candidemia and 23 (3.8%) patients were free of catheter colonization. There were no statistically significant differences in baseline characteristics between patients with persistent and non-persistent candidemia. In univariate analysis, less use of metronidazole, glycopeptide, fluoroquinolone, and aminoglycoside, and presence of Candida parapsilosis were significantly associated with persistent candidemia. In multivariate analysis, less use of metronidazole was an independent factor associated with persistent candidemia. The candidemia related mortality was insignificantly (P =0.094) higher in persistent candidemia than non-persistent candidemia. Conclusions: Persistent candidemia can occur without catheterization. Patterns of antibiotic use could be associated with the occurrence of persistent candidemia, and prognosis of persistent candidemia seems to be worse than non-persistent candidemia. Further studies for persistent candidemia should be performed.

AB - Background: Candidemia is one of the most common causes of nosocomial bloodstream infection, and increases the morbidity and mortality rate of seriously ill patients. We evaluated the risk factors and outcomes associated with persistent candidemia without catheter colonization (non-catheter related candidemia) and compared them with those of non-persistent candidemia. Materials and Methods: A retrospective case-control study was performed to identify risk factors for, and outcomes of, persistent candidemia. All adults who experienced candidemia in a university-affiliated hospital in Korea between January 2005 and December 2009 were included. Patients with catheter colonization were excluded. Persistent candidemia was defined as the occurrence of candidemia in a patient receiving at least 3 days of systemic antifungal agents prior to the second positive blood culture. Results: Of 605 adult patients with candidemia, 104 (17.2%) patients had persistent candidemia and 23 (3.8%) patients were free of catheter colonization. There were no statistically significant differences in baseline characteristics between patients with persistent and non-persistent candidemia. In univariate analysis, less use of metronidazole, glycopeptide, fluoroquinolone, and aminoglycoside, and presence of Candida parapsilosis were significantly associated with persistent candidemia. In multivariate analysis, less use of metronidazole was an independent factor associated with persistent candidemia. The candidemia related mortality was insignificantly (P =0.094) higher in persistent candidemia than non-persistent candidemia. Conclusions: Persistent candidemia can occur without catheterization. Patterns of antibiotic use could be associated with the occurrence of persistent candidemia, and prognosis of persistent candidemia seems to be worse than non-persistent candidemia. Further studies for persistent candidemia should be performed.

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