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. 2021 Apr 1;7(4):269.
doi: 10.3390/jof7040269.

Risk Factors and Outcomes of Non- albicans Candida Bloodstream Infection in Patients with Candidemia at Siriraj Hospital-Thailand's Largest National Tertiary Referral Hospital

Chaiyapong Ngamchokwathana  1 , Piriyaporn Chongtrakool  2 , Amiroh Waesamaae  3 , Methee Chayakulkeeree  4
Affiliations

Risk Factors and Outcomes of Non- albicans Candida Bloodstream Infection in Patients with Candidemia at Siriraj Hospital-Thailand's Largest National Tertiary Referral Hospital

Chaiyapong Ngamchokwathana et al. J Fungi (Basel). .

Abstract

This study aimed to investigate the risk factors for and the outcomes of patients with candidemia caused by non-albicans Candida. Candidemia patients treated at Siriraj Hospital (Bangkok, Thailand) during January 2016 to December 2017 were enrolled. A total of 156 patients (mean age: 65 years, 56.4% male) were included. The most prevalent underlying conditions were diabetes (32.1%), chronic cardiac disease (28.2%), chronic kidney disease (26.9%), and hematologic malignancies (21.2%). Candida species isolated from patient blood were C. tropicalis (49.4%), C. albicans (28.8%), C. glabrata (16.7%), and C. parapsilosis (5.1%). Fluconazole resistance was significantly increased in C. tropicalis (37.8%). No independent risk factors were associated with patients with non-albicans Candida candidemia compared to those with C. albicans candidemia. There was no significant difference in mortality between patients with non-albicans Candida candidemia and patients with C. albicans candidemia (OR: 1.35, 95% CI: 0.64-2.85). When compared with C. albicans candidemia, multivariate analysis revealed chronic liver disease (OR: 11.39, 95% CI: 1.38-94.02), neutropenia (OR: 4.31, 95% CI: 1.34-13.87), and male gender (OR: 2.34, 95% CI: 1.04-5.29) to be independent risk factors for C. tropicalis candidemia. The observed high resistance of C. tropicalis to fluconazole indicates that fluconazole should not be used for empirical antifungal treatment in these patients.

Keywords: Candida; Thailand; candidemia; candidiasis; non-albicans Candida; outcomes; risk factors.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Species distribution of Candida isolated from blood samples of patients with candidemia.
Figure 2
Figure 2
Antifungal susceptibility of Candida isolates.
See this image and copyright information in PMC

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