Characteristics of candidaemia with Candida-albicans compared with non-albicans Candida species and predictors of mortality.

Internal Medicine C and Infectious Diseases, Rabin Medical Centre, Beilinson Campus, Petach Tikva, Israel.
Journal of Hospital Infection (Impact Factor: 2.78). 11/2005; 61(2):146-54. DOI: 10.1016/j.jhin.2005.02.009
Source: PubMed

ABSTRACT Candidaemia due to non-albicans Candida species is increasing in frequency. We describe 272 episodes of candidaemia, define parameters associated with Candida albicans and other Candida species, and analyse predictors associated with mortality. Patients with C. albicans (55%) had the highest fatality rate and frequently received immunosuppressive therapy, while patients with Candida parapsilosis (16%) had the lowest fatality and complication rates. Candida tropicalis (16%) was associated with youth, severe neutropenia, acute leukaemia or bone marrow transplantation, Candida glabrata (10%) was associated with old age and chronic disease, and Candida krusei (2%) was associated with prior fluconazole therapy. The overall fatality rate was 36%, and predictors of death by multi-variate analysis were shock, impaired performance status, low serum albumin and congestive heart failure. Isolation of non-albicans Candida species, prior surgery and catheter removal were protective factors. When shock was excluded from analysis, antifungal therapy was shown to be protective. Unlike previous concerns, infection with Candida species other than C. albicans has not been shown to result in an increased fatality rate.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Over the last decades, Candida spp have been responsible for an increasing number of infections, especially in patients requiring intensive care. Knowledge of local epidemiology and analysis of the spread of these pathogens is important in understanding and controlling their transmission. The aim of this study was to evaluate the genetic diversity of 31 Candida albicans and 17 Candida glabrata isolates recovered from intensive care unit patients from the tertiary hospital in Krakow between 2011-2012. The strains were typed by random amplified polymorphic DNA (RAPD) polymerase chain reaction using five primers (CD16AS, HP1247, ERIC-2, OPE-3 and OPE-18). The results of the present investigation revealed a high degree of genetic diversity among the isolates. No clonal relationship was found among the C. albicans strains, whereas two C. glabrata isolates were identical. The source of Candida infection appeared to be mostly endogenous; however, the presence of two clonal C. glabrata strains suggested the possibility of cross-transmission of these pathogens. Our study confirmed the high discriminatory power of the RAPD technique in the molecular typing of Candida clinical isolates. This method may be applied to the evaluation of transmission routes of pathogenic fungi on a local level.
    Memórias do Instituto Oswaldo Cruz 06/2014; 109(4):436-441. · 1.36 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: La candidemia es una patología con alta morbilidad y mortalidad, especialmente en los pacientes sometidos a servicios de cuidado crítico. El diagnóstico precoz permite realizar tratamiento temprano. Objetivos: Realizar una revisión sistemática de la literatura para establecer cuáles son las pruebas de laboratorio con mejor rendimiento diagnóstico y operativo para el diagnóstico de candidemia en cuidado intensivo. Materiales y Métodos: Se realizó una revisión sistemática de la literatura disponible en PubMed, se sometieron a meta-análisis estudios de pruebas serológicas en MetaDisc-Beta 1.1.1. Resultados: Se incluyeron 4 estudios de 1.286 revisados, 3 de pruebas serológicas y 1 de RPC-RT. La sensibilidad y especificidad fue de 87 y 100% para RPC-RT, 47,5 y 82,6% para pruebas de anticuerpos, 96 y 81% para pruebas de antígeno y anticuerpo. La ORD de antigenemia 1,51(IC95% = 0,03270,964; p = 0,001). Conclusiones: RPC-RT tiene mejor rendimiento diagnóstico, la medición de antigenemia más anticuerpos mejora la sensibilidad, especificidad, LR+ y LR-. No hay suficiente evidencia que soporte esto.
    Revista chilena de infectologia: organo oficial de la Sociedad Chilena de Infectologia 10/2011; 28(5):423-428. · 0.50 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Aufgrund der steigenden Anzahl immunsupprimierter Patienten nach Organstransplantation oder antineoplastischer Chemotherapie gewinnen Pilzinfektionen weltweit zunehmend an Bedeutung. Zukünftig wird – vor dem Hintergrund bereits durchgeführter präklinischer Studien – eine Vielzahl klinischer Studien hinsichtlich genmanipulierter Vakzine durchgeführt. Die klassischen Vakzinherstellungsmethoden, die bei vielen viralen und bakteriellen Infektionen erfolgreich sind, sind jedoch für die Gewinnung antimykotischer Vakzine nur bedingt übertragbar, da deren Immunantwort überwiegend zellulär vermittelt ist.
    Der Hautarzt 01/2008; 59(10). · 0.54 Impact Factor