M-2127a. Review of 2019 Patients with Candidemia through the PATH Alliance Registry
Session: Poster Session: Clinical Mycology I
Monday, October 27, 2008: 12:00 AM
Room: Hall C
Background: We assessed the epidemiology and mortality of 2019 patients (pts) with candidemia (1 episode with 1 Candida spp). Data was collected by the multicenter, observational PATH Alliance Registry from 2004-2008.
Methods: Chi-square or Fisher’s exact tests were used to assess the associations between Candida spp and demographics, risk factors and therapy; 12-week survival outcomes across spp were compared using the log-rank test. Results: Among the 2019 pts, C. albicans (45.6%) was the most common, followed by C. glabrata (26.0%), C. parapsilosis (15.7%), C. tropicalis (8.1%), C. krusei (2.5%), C. lusitaniae (0.8%), C. dubliniensis (0.4%), C. guillermondii (0.3%), and other/unknown spp. (0.7%). Pts with C. parapsilosis were less likely to be neutropenic (5.1%, P < 0.0001) and receive corticosteroids (33.5%, P = 0.0002) or other immunosuppressants (7.9%; P = 0.002). C. krusei candidemia was associated with prior use of antifungal agents (70.6%), hematologic malignancy (52.9%) or SCT (17.7%), neutropenia (45.1%; all, P < 0.0001), and corticosteroids (60.8%; P = 0.0002). Fluconazole (67.7%) and the echinocandins (48.9%) were most commonly used. The overall, crude 12-week mortality was 35.2%, with C. parapsilosis and C. krusei candidemia having the lowest (23.7%) and highest mortality (52.9%), respectively (P < 0.0001). Conclusions: This is the largest contemporary cohort of pts with candidemia ever reported. Collectively, non-albicans Candida spp were the most common cause. Mortality remains high in pts with candidemia, with significant differences observed among the Candida spp. The PATH Alliance Registry can be used to analyze large numbers of pts with invasive fungal infections.
Karen Webster, Axiom Real-Time Metrics, Inc, Kieren Marr, MD, Fred Hutchinson Cancer Research Center, Seattle, WA, Michael A. Pfaller, M.D., Microbiology, JMI Laboratories, North Liberty, IA, William Steinbach, MD, FIDSA, Duke University Medical Center, Durham, NC, Ali Olyaei, PharmD, Oregon Health & Science University, Portland, OR, Chi-Hsing Hsing, Info-Spectrum, Inc, David Horn, MD, Thomas Jefferson Univ., Philadelphia, PA, Dennis Neofytos, MD, Thomas Jefferson University Hospital, Elias Anaissie, MD, University of Arkansas for Medical Sciences, Little Rock, AR, Jay Fishman, MD, FIDSA, I D Unit, Massachusetts General Hospital, Boston, MA and  D. Horn,
Roche Role(s): Consultant, Received: Speaker Honorarium.
Astellas Role(s): Grant Investigator, Scientific Advisor (Review Panel or Advisory Committee), Speaker's Bureau, Received: Grant Recipient, Speaker Honorarium, Consulting Fee.

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