Clinical and Laboratory Features of Candidemia Caused by Different Candida Species

Oh, Bong Joon; Choi, Hyun Woo; Lee, Jin Sol; Cho, Duck; Kee, Seung Jung; Shin, Myung Geun; Shin, Jong Hee; Suh, Soon Pal; Ryang, Dong Wook

Abstract

BACKGROUND
Recently, the incidence of candidemia due to Candida species other than C. albicans have increased. In this study, we analyzed the laboratory and clinical characteristics of candidemia caused by four different Candida species (C. albicans, C. parapsilosis, C. tropicalis and C. glabrata) occurring at Chonnam National University Hospital (CNUH). METHODS: The demographic, clinical and microbiological data of 157 patients with candidemia at CNUH from 1996 to 2002 was analyzed, retrospectively. The etiologic agents for 157 cases of candidemia were C. albicans (n=48), C. parapsilosis (n=48), C. tropicalis (n=32) and C. glabrata (n= 29). The characteristics of candidemia due to each single Candida species were compared with those with all other species combined. RESULTS: Although the majority (77%) of candidemic patients were adults, candidemia due to C. albicans or C. parapsilosis occurred significantly more often in premature infants (15%, retrospectively, P=0.002), in comparison with other Candida species (0%). Candidemia due to C. glabrata was more common in patients with neutropenia (41%, P<0.001), and they also occurred frequently in the absence of central venous catheter related candidemia (86%, P<0.001). Bloodstream infections with C. parapsilosis were more frequently the cause of catheter related candidemia (56%, P=0.012), and they had a better clinical outcome (90%, P=0.004) than those with other Candida species. CONCLUSIONS: This study confirms that some characteristics of candidemia such as age, underlying conditions, relatedness of catheter, and outcome can be different according to the species of Candida.