Epidemiology and outcome of multiple-species candidemia at a tertiary care center between 2004 and 2007

Abstract

The incidence of multiple-species candidemia (MSC) among cases of candidemia ranges between 2.8% and 8.0%. We sought to study the epidemiology and outcome of MSC at a tertiary care center. A retrospective analysis of MSC episodes occurring between 2004 and 2007 was performed. MSC was defined as > or =2 different Candida spp. growing concomitantly within the same blood culture bottle or within 72 h of each other. Information on demographics, comorbidities, antifungal use, and survival was collected. Forty MSC patients with 81 Candida isolates were identified. Non-albicans Candida spp. (54 of 81 isolates, 66.7%) were more frequently identified. The most common combinations observed were Candida albicans/Candida glabrata (15 of 40 patients, 37.5%), C. albicans/Candida parapsilosis (8, 20.0%), and C. glabrata/Candida krusei (5, 12.5%). The overall crude 4- and 12- week mortality, excluding patients lost to follow-up, was 41.9% and 66.7%, respectively. In this contemporary sampling of patients with MSC, the combination of C. albicans/C. glabrata was most frequently observed and mortality was high.