1604. Candidemia and Endogenous Endophthalmitis at a Tertiary Care Center: Largest Case Series in Japan
Session: Poster Abstract Session: Mycology - There's a Fungus Among Us: Epidemiology
Friday, October 28, 2016
Room: Poster Hall
Posters
  • IDSA poster Candidemia NM.pdf (2.3 MB)
  • Background:

    Candidemia is a devastating healthcare-related infection with high mortality rate over 50% and can cause endogenous candida endophthalmitis (CE), which is a rare but major sight-threatening complication and can be manifested as isolated chorioretinitis or as chorioretinitis with vitritis. However, the species of candida and incidence of CE varies according to institution and geographic location. There are only sporadic case series and little is known about clinical and microbiological features of candidemia and CE in Japan.

    Methods:

    We retrospectively reviewed charts of all patients with candidemia at St. Luke’s International Hospital (tertiary care center with 520 patient beds) in Tokyo, Japan, from July 2004 to December 2015. We investigated basic demographics, species of candida, site of infection, rate of endophthalmitis, and clinical outcomes.

    Results:

    We identified 228 cases in total. Median age was 75 (0 – 104) with 3:2 male to female ratio. Roughly half of them had underlying malignancy (38% of solid tumor and 11% of hematological malignancy). Twenty (9%) had neutropenia at the time of candidemia. Most common species was C. albicans (120, 53%), followed by C. glabrata (50, 22%), C. parapsilosis (26, 11%), C. tropicalis(22, 10%) and others. The most commonly affected site of infection was central line associated bloodstream infections (116, 73%), followed by gastrointestinal (28, 12%), urinary tract (11, 5%) and others. Infectious Diseases consultation was requested in 124 (54%) and dilated retinal examination was performed in 192 (84%). Ocular involvement was seen in 42 (22%); 40 had isolated chorioretinitis, while 2 had chorioretinitis with vitritis. 30-day and 90-day mortality rate was 36% and 53%, respectively.

    Conclusion:

    To our knowledge, this is the largest case series to describe clinical and microbiological characteristics of candidemia and CE in Japan. Knowing the local factors such as prevalence of non-albicans is of paramount importance for empirical and definitive antifungal therapy.

    Nobuyoshi Mori, MD, Takahiro Matsuo, MD, Aki Sakurai, MD and Keiichi Furukawa, MD, FSHEA, Infectious Diseases, St. Luke's International Hospital, Tokyo, Japan

    Disclosures:

    N. Mori, None

    T. Matsuo, None

    A. Sakurai, None

    K. Furukawa, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.