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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
MeSH
APACHE ; Adult ; Aged ; Candida glabrata* ; Candidiasis/drug therapy ; Candidiasis/epidemiology ; Candidiasis/etiology* ; Female ; Fluconazole/therapeutic use ; Fungemia/drug therapy ; Fungemia/epidemiology ; Fungemia/etiology* ; Humans ; Incidence ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors
Keywords
Candidemia ; Risk factors ; Mortality
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.
Files in This Item:
T200902811.pdf Download
DOI
10.3904/kjim.2009.24.3.263
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
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Kim, June Myung(김준명)
Kim, Chang Oh(김창오) ORCID logo https://orcid.org/0000-0002-0773-5443
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Lee, Han Sung(이한성)
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Chin, Bum Sik(진범식)
Choi, Suk Hoon(최석훈)
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
Choi, Hee Kyoung(최희경)
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104400
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