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Blood Stream Infections by Candida glabrata and Candida krusei: A Single-Center Experience

Authors
 Hee Kyoung Choi  ;  Su Jin Jeong  ;  Han Sung Lee  ;  Bum Sik Chin  ;  Suk Hoon Choi  ;  Sang Hoon Han  ;  Myung Soo Kim  ;  Chang Oh Kim  ;  Jun Yong Choi  ;  Young Goo Song  ;  June Myung Kim 
Citation
 Korean Journal of Internal Medicine, Vol.24(3) : 263-269, 2009 
Journal Title
 Korean Journal of Internal Medicine 
ISSN
 1226-3303 
Issue Date
2009
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.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
김명수(Kim, Myoung Soo) ORCID logo https://orcid.org/0000-0002-8975-8381
김준명(Kim, June Myung)
김창오(Kim, Chang Oh) ORCID logo https://orcid.org/0000-0002-0773-5443
송영구(Song, Young Goo) ORCID logo https://orcid.org/0000-0002-0733-4156
이한성(Lee, Han Sung)
정수진(Jeong, Su Jin) ORCID logo https://orcid.org/0000-0003-4025-4542
진범식(Chin, Bum Sik)
최석훈(Choi, Suk Hoon)
최준용(Choi, Jun Yong) ORCID logo https://orcid.org/0000-0002-2775-3315
최희경(Choi, Hee Kyoung)
한상훈(Han, Sang Hoon) ORCID logo https://orcid.org/0000-0002-4278-5198
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104400
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