1596. Current Trends in Candidemia and Species Distribution Among Adults: Candida glabrata Surpasses C. albicans in Diabetic Patients and Abdominal Sources. 
Session: Poster Abstract Session: Mycology - There's a Fungus Among Us: Epidemiology
Friday, October 28, 2016
Room: Poster Hall
Posters
  • Slide1.GIF (750.8 kB)
    • Background:  The rate of candidemia and species distribution vary according to the type of patients, country of origin and antifungal prophylaxis use. We present current epidemiological trends of candidemia at a 772-bed teaching hospital.

    Methods: 

    A retrospective examination of candidemia in adults (≥18 years-old) hospitalized from 2007 to 2015. Cases were identified through the microbiology laboratory. Candidaspecies were distinguished based on colony morphology and VITEK-2 YBC cards, (bioMerieux, Durham, NC). Patient characteristics, species distribution, source and outcome were assessed.

    Results: 

    We encountered 275 patients with candidemia. The rate of candidemia dropped in 2010 (p=0.0002) without further decline. Nearly all cases (97.4%) were healthcare-associated. C. albicans and C. glabrata proportions varied without a discernable trend. C. glabrata was more common in diabetics (52.9% vs. 32.0% [non-diabetics]; p=0.004) and abdominal sources (53.3% vs. 35.5%, [other sources] p=0.03), especially in gastric/duodenal foci (88.9% vs. 44.1% [other abdominal foci]; p=0.02). All-cause 30-day mortality rate was 43.3% without changes over time. C. parapsilosis-related mortality was low (25.0%) compared to C. albicans (43.2%) and C. glabrata (48.7%). 

    Candidemia among adults: changing Candida species over time: n (%).

    Candida species

    Year (No)

    C. albicans

    C. glabrata

    C. parapsilosis

    Other spp.

    2007 (34)a

    20 (55.6)

    8 (22.2)

    3 (8.3)

    5 (13.9)

    2008 (47)

    18 (38.3)

    17 (36.2)

    8 (17.0)

    4 (8.5)

    2009 (41)b

    18 (42.9)

    7 (16.7)

    8 (19.0)

    9 (21.4)

    2010 (23)

    12 (52.2)

    8 (34.8)

    2 (8.7)

    1 (4.3)

    2011 (29)a

    15 (48.3)

    10 (32.3)

    4 (12.9)

    2 (6.5)

    2012 (27)b

    7 (25.0)

    13 (46.4)

    3 (10.7)

    5 (17.9)

    2013 (21)

    8 (38.1)

    6 (28.6)

    2 (9.5)

    5 (23.8)

    2014 (23)b

    10 (41.7)

    8 (33.3)

    2 (8.3)

    4 (16.7)

    2015 (30)a

    17 (53.1)

    5 (15.6)

    6 (18.8)

    4 (12.5)

    Pc

    0.7

    0.9

    0.2

    0.4

    a: two patients, each with two species; b: one patient with two species; c: extended Mantel-Haenszel chi square for linear trend.

    Conclusion: 

    Candidemia rate remains stable after a decline in 2010. C. albicans remains the most common species but C. glabratapredominates in diabetics and abdominal sources. These findings suggest possible species-related differences in colonization dynamics and/or pathogenicity.

    Riad Khatib, MD1, Leonard B. Johnson, MD, FIDSA2, Mohamad Fakih, MD, MPH, FIDSA1, Kathleen Riederer, BS, MT1 and Laurence Briski, MD3, (1)Medicine, St. John Hospital & Medical Center, Grosse Pointe Woods, MI, (2)Internal Medicine, St. John & Medical Center, Detroit, MI, (3)Pathology, St. John Hospital & Medical Center, Grosse Pointe Woods, MI

    Disclosures:

    R. Khatib, None

    L. B. Johnson, None

    M. Fakih, None

    K. Riederer, None

    L. Briski, None

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