209. Clinical characteristics and risk factors for mortality in patients with persistent candidemia
Session: Poster Abstract Session: Candida Infection
Thursday, October 8, 2015
Room: Poster Hall
Background: The clinical characteristics and outcomes of persistent candidemia are poorly understood in spite of high attributable mortality of candidemia. This study was performed to investigate the clinical characteristics and risk factors for mortality in patients with persistent candidemia.

Methods: All patients ≥18 years old with candidemia from 2007 to 2014 at 2 tertiary hospitals in Korea were investigated. Persistent candidemia was defined as the isolation of the same Candida species ≥ 5 days after the initiation of antifungal therapy. Non-persistent candidemia was defined as candidemia persisting for ≤ 3 days after initiation of antifungal therapy.

Results: : Of a total of 538 patients with candidemia, 80 (14.9%) had persistent candidemia. C. tropicalis (26%) was the most common pathogen of persistent candidemia, followed by C. albicans (24%) and C. parapislosis (23%). The persistent candidemia group had significantly longer hospitalization prior to candidemia (31.9 ± 38.2 days vs. 19.8 ± 24.1 days; p= 0.013) and higher presence of central venous catheters (65.0% vs. 45.0%; p=0.006) and severe sepsis at diagnosis of candidemia (21.3 % vs. 9.2%; p=0.022) than the non-persistent group. The 30-day mortality was 37% among those with persistent candidemia and 27% among those with non-persistnet candidemia (p=0.149). C. tropicals candidemia (OR 3.71; 95% CI 1.29-10.67; p=0.016) was independent predictors of mortality in persistent candidemia, while male gender (OR 18.09; 95% CI 2.75-118.92; p=0.003), severe sepsis (OR 10.74; 95% CI 1.56-73.79; p=0.016) were predictors of mortality in non-persistent candidemia.

Conclusion: C. tropicalis is the predominant cause of persistent candidemia. It is associated with poor outcome in persistent candidemia. Aggressive approach in patients with persistent candidemia caused by C. tropicalis should be encouraged.

Seung Ji Kang, MD1, Ji-Eun Kim, resident2, Uh-Jin Kim, clinical fellowship3, Joon Hwan An, clinical fellowship4, Hee-Chang Jang, MD5, Kyung Hwa Park, MD5, Jong Hee Shin, PHD6 and Sook in Jung, MD5, (1)Chonnam National University Hwasun hospital, Hwasun-Gun, South Korea, (2)Chonnam national university, Kwang ju, South Korea, (3)Infectious Disease, Chonnam national university, Kwang ju, South Korea, (4)Infectious Disease, Chonnam National Universty Hospital, Kwang ju, South Korea, (5)Chonnam National University Medical School, Gwangju, South Korea, (6)Laboratory Medicine, Chonnam National University Medical School, Gwang-ju, South Korea

Disclosures:

S. J. Kang, None

J. E. Kim, None

U. J. Kim, None

J. H. An, None

H. C. Jang, None

K. H. Park, None

J. H. Shin, None

S. I. Jung, None

See more of: Candida Infection
See more of: Poster Abstract Session

Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.