Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-15T05:57:09.372Z Has data issue: false hasContentIssue false
  • English
  • Français

Breakthrough Candidemia in Patients with Cancer Differs from De Novo Candidemia in Host Factors and Candida Species But Not Intensity

Published online by Cambridge University Press:  02 January 2015

Dimitrios P. Kontoyiannis ,
Bhavanandra T. Reddy ,
Hend Hanna ,
Gerald P. Bodey ,
Jeffrey Tarrand  and
Issam I. Raad
Dimitrios P. Kontoyiannis*
Affiliation:
The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Bhavanandra T. Reddy
Affiliation:
The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Hend Hanna
Affiliation:
The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Gerald P. Bodey
Affiliation:
The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Jeffrey Tarrand
Affiliation:
The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Issam I. Raad
Affiliation:
The University of Texas M.D. Anderson Cancer Center, Houston, Texas
*
Department of Infectious Diseases, Infection Control & Employee Health, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 402, Houston, Texas
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To evaluate the risk factors associated with breakthrough candidemia in patients with cancer and to compare them with those of de novo candidemia in this patient population. DESIGN: Retrospective case series of 120 episodes of candidemia, 90 de novo and 30 breakthrough candidemias.

Setting:

University-affiliated, tertiary-care cancer center in Houston, Texas.

Patients:

All patients with cancer who acquired candidemia between January 1993 and December 1998 were included if they had non-catheter-related candidemia and information about quantitative blood cultures.

Results:

Although less frequent, breakthrough candidemia was seen more often in neutropenic patients with leukemia. The intensity of breakthrough candidemia was comparable to that of de novo candidemia. Most (70%) of the breakthrough candidemias were due to Candida glabrata or C. krusei.

Conclusions:

In breakthrough candidemia, the same risk factors seen in de novo candidemia were encountered, although more frequently. C. glabrata and C. krusei are the leading causes of breakthrough candidemia in patients with cancer.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 9 , September 2002 , pp. 542 - 545
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Abi-Said, D, Anaissie, E, Uzun, O, Raad, I, Pincowski, H, Vartivarian, S. The epidemiology of hematogenous candidiasis caused by different Candida species. Clin Infect Dis 1997;24:1122–1128.Google Scholar
2.Viscoli, C, Girmenia, C, Marinus, Aet al. Candidemia in cancer patients: a prospective, multi-center surveillance study by the Invasive Fungal Infection Group (IFIG) of the European Organization for Research and Treatment of Cancer (EORTC). Clin Infect Dis 1999;28:1071–1079.Google Scholar
3.Nguyen, MH, Peacock, JE, Morris, AJ, et al. The changing face of candidemia: emergence of non-Candida albicans species and antifungal resistance. Am J Med 1996;100:617–623.Google Scholar
4.Nucci, M, Colombo, AI, Spector, N, Velasco, E, Martins, A, Pulcheri, W. Breakthrough fungemia in neutropenic patients. Clin Infect Dis 1997; 24:275–276.CrossRefGoogle ScholarPubMed
5.Girmenia, C, Marino, P, Cassone, A. Breakthrough candidemia during antifungal treatment with fluconazole in patients with hematologic malignancies. Blood 1996;87:838–839.CrossRefGoogle ScholarPubMed
6.Rex, JH. Editorial response: catheters and candidemia. Clin Infect Dis 1996;22:467–470.CrossRefGoogle ScholarPubMed
7.Tarrand, JJ, Guillot, C, Wenglar, M, Jackson, J, Lajeunesse, J, Rolston, K. Clinical comparison of the resin-containing BACTEC26 Plus and the isolator 10 blood culturing systems. J Clin Microbiol 1991;29:2245–2249.CrossRefGoogle ScholarPubMed
8.Blumberg, EA, Reboli, AC. Failure of empirical therapy with amphotericin B to prevent candidemia in neutropenic patients with cancer. Clin Infect Dis 1996;22:462–466.Google Scholar
9.Uzun, O, Ascioglu, S, Anaissie, EJ, Rex, JH. Risk factors and predictors of outcome in cancer patients with breakthrough candidemia. Clin Infect Dis 2001;32:1713–1717.Google Scholar
10.Fisher, MA, Shen, S-H, Haddad, J, Tarry, WF. Comparison of in vivo activity of fluconazole with that of amphotericin B against Candida tropicalis, Candida glabrata, and Candida krusei. Antimicrob Agents Chemother 1989;33:1443–1446.Google Scholar