Poor prognosis of Candida tropicalis among non-albicans candidemia: a retrospective multicenter cohort study, Korea

• Published in: Diagnostic microbiology and infectious disease 2019-10, Vol.95 (2), p.195-200
• Main Authors: Ko, Jae-Hoon, Jung, Dong Sik, Lee, Ji Yeon, Kim, Hyun Ah, Ryu, Seong Yeol, Jung, Sook-In, Joo, Eun-Jeong, Cheon, Shinhye, Kim, Yeon-Sook, Kim, Shin-Woo, Cho, Sun Young, Kang, Cheol-In, Chung, Doo Ryeon, Lee, Nam Yong, Peck, Kyong Ran
• Format: Article
• Language: English
• Subjects: Aged; Antifungal Agents - therapeutic use; APACHE; Candida - isolation & purification; Candida - physiology; Candida tropicalis; Candida tropicalis - isolation & purification; Candida tropicalis - physiology; Candidemia - diagnosis; Candidemia - drug therapy; Candidemia - microbiology; Candidemia - mortality; Clinical outcome; Female; Hospitals, University; Humans; Male; Middle Aged; Non-albicans candidemia; Poor prognosis; Prognosis; Republic of Korea - epidemiology; Retrospective Studies; Risk Factors; Survival Rate
• ISSN: 0732-8893; 1879-0070
• DOI: 10.1016/j.diagmicrobio.2019.05.017

To evaluate clinical features and prognostic factors of non-albicans candidemia, we conducted a retrospective multicenter cohort study at 7 university hospitals in Korea from January 2010 to February 2016. A total of 721 patients with non-albicans candidemia were included in the analysis. C. tropicalis was most commonly identified (36.5%), followed by C. glabrata (27.2%), C. parapsilosis (25.7%), and C. krusei (2.4%). Clinical presentation of C. tropicalis candidemia was most severe with highest median C-reactive protein level (10.1 mg/dL) and Acute Physiology and Chronic Health Evaluation II score (14, both P ≪ 0.05). C. tropicalis showed the highest 14- and 30-day mortality (28.9% and 44.1%). In multivariate analysis, C. tropicalis infection was significantly related with 14- (P = 0.005) and 30-day mortality (P = 0.033). In conclusion, C. tropicalis infection presented most severely and showed worst clinical outcome among non-albicans candidemia. •A multicenter cohort study was conducted for non-albicans candidemia.•Clinical presentation of C. tropicalis candidemia was most severe.•APACHE II score and C. tropicalis infection were associated with mortality.•Types of antifungal agents were not associated with outcome.