Characteristics of late recurrent candidemia in adult patients

Background and objectives Candida species are one of the most common causes of health care‐associated bloodstream infections. However, recurrent candidemia is rare, and the characteristics of late recurrent (LR) candidemia are partly unclear. Our aim was to evaluate the characteristics of LR candide...

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Bibliographic Details
Published in:Mycoses 2021-05, Vol.64 (5), p.503-510
Main Authors: Ala‐Houhala, Mari, Anttila, Veli‐Jukka
Format: Article
Language:English
Subjects:
adult patients
Candidemia
characteristics
Chronic infection
gastrointestinal disease
Gastrointestinal diseases
Gastrointestinal tract
Hospitals
Patients
recurrent candidemia
Risk factors
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Summary:Background and objectives Candida species are one of the most common causes of health care‐associated bloodstream infections. However, recurrent candidemia is rare, and the characteristics of late recurrent (LR) candidemia are partly unclear. Our aim was to evaluate the characteristics of LR candidemia in adult patients. Patients and Methods A retrospective cohort study was performed in the hospital district of Helsinki and Uusimaa in Finland (2007‐2016). All candidemia cases were searched in an electronic database during the study period. Patients with LR candidemia were compared with patients with a single candidemia episode to evaluate the characteristics of LR candidemia. LR candidemia was defined as having at least two episodes of candidemia more than 30 days apart. Results We identified 24 episodes of LR candidemia in 20 patients. Patients with LR candidemia represented 6% of all patients with candidemia during the study period, and most of these cases were nosocomial. The median time between the first and the recurrent episode was 5.1 months. One‐year mortality in LR candidemia was 45%. Underlying gastrointestinal disease (OR 7.21, 95% CI 2.52‐20.61) and history of intra‐venous drug use (IVDU) (OR 3.62, 95% CI 1.03‐12.69) were independent risk factors for LR candidemia in the multivariable analysis. Conclusion Our study indicates that the gastrointestinal tract may be a continuous source of infection in patients with chronic gastrointestinal diseases. Gastrointestinal diseases and IVDU should be regarded as risk factors for LR candidemia.
ISSN:0933-7407
1439-0507
DOI:10.1111/myc.13236