While the global epidemiology of candidemia has been studied in detail, there is relatively little data examining the effect of recent changes in antifungal usage patterns on the susceptibility and distribution of Candida species. Likewise, there is relatively little data documenting outcomes in patients with candidemia.
Chart review was conducted of patients at Moffitt Cancer Center, Tampa, FL with candidemia between January 1, 2001 and June 18, 2014. Patients were selected based on one or more positive peripheral and central line blood cultures; catheter tips were excluded. The yeast species had been cultured on Sabouraud dextrose and chocolate agars and identified using either the RapID Yeast One system or the Vitek 2 system. Drug susceptibilities were determined using the TREK Sensititre YeastOne system.
Data on exposure to fluconazole, amphotericin B, voriconazole, micafungin, 5-flucytosine, posaconazole, caspofungin, itraconazole, and anidulafungin was collected. Analysis was conducted by comparing the frequencies of each Candida species over specified time intervals for all patients, those with non-hematological malignancies, and those with hematological malignancies.
247 candidemic patients were identified, 115 of them with hematologic malignancies. The most prevalent infecting species was C. albicans which grew in slightly less than half of non-hematological malignancy patients. The most prevalent infecting species for patients with hematological malignancies was C. glabrata followed by C. krusei, which combined for more than half of infections. C. albicans was not as frequent in this group, and was the least prevalent of the major species. Over time, incidences of C. albicans and C. tropicalis fell, while C. parapsilosis and C. krusei rose. Eleven deaths were deemed attributable to candidemia in comparison to 40 deaths deemed attributable to underlying disease.
D. Jani, None
R. Quilitz, None
S. Carraway, None
R. Sandin, None
J. Greene, None