Candida Glabrata Fungemia. Clinical Features of 139 Patients

Medicine (Baltimore). 1999 Jul;78(4):220-7. doi: 10.1097/00005792-199907000-00002.

Abstract

Candida species are now the fourth leading cause of nosocomial bloodstream infection in hospitalized patients, and non-Candida albicans species now surpass Candida albicans. The clinical features of the most common non-Candida albicans species, Candida (Torulopsis) glabrata, have not been well studied. We retrospectively reviewed the clinical features of 139 patients with C. glabrata blood-stream infection over a period of 7 years. The mean age of patients was 62 years, and the most common admitting diagnoses were malignancy (28%) and coronary artery disease (18%). The most common identified portals of entry were abdominal (22%) and intravascular catheters (16%). At the time of fungemia, 63% of patients had fever, 45% had change in mental status, and 30% were in septic shock. Three of 50 patients examined by an ophthalmologist had chorioretinitis. The overall hospital mortality was 49%. Factors associated with increased mortality in a regression model were prior abdominal surgery (odds ratio [OR] = 2.8; 95% confidence interval [CI] = 1.2-6.3, p = 0.01), and an elevated creatinine (OR = 2.2; 95% CI = 1.0-4.7, p = 0.05). When early deaths (< or = 72 hours) were censored, amphotericin B treatment and total dose were associated with reduced mortality (OR = 0.2; 95% CI = 0.1-0.4, p < 0.001). Nosocomial C. glabrata fungemia is not just a disease of debilitated and neutropenic patients, but affects a wide variety of patients and is associated with a high mortality.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Candidiasis* / complications
  • Candidiasis* / drug therapy
  • Candidiasis* / epidemiology
  • Candidiasis* / microbiology
  • Cross Infection* / complications
  • Cross Infection* / drug therapy
  • Cross Infection* / epidemiology
  • Cross Infection* / microbiology
  • Female
  • Fungemia* / complications
  • Fungemia* / drug therapy
  • Fungemia* / epidemiology
  • Fungemia* / microbiology
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Ohio / epidemiology
  • Retrospective Studies
  • Statistics, Nonparametric
  • Treatment Outcome