Prospective evaluation of Candida species colonization in hospitalized cancer patient: Impact on short-term survival in recipients of marrow transplatation and patients with hematological malignancies Journal Article


Authors: Safdar, A.; Armstrong, D.
Article Title: Prospective evaluation of Candida species colonization in hospitalized cancer patient: Impact on short-term survival in recipients of marrow transplatation and patients with hematological malignancies
Abstract: Most hematogenous candidiasis originates from endogenous host flora. The impact of clinically prominent Candida colonization on short-term mortality (≤14 weeks) was prospectively studied in 193 hospitalized patients from 1998 to 1999. Clinically prominent colonization included yeasts isolated from all sterile body sites and >50 colonies of Candida from non-sterile sites. Fourteen (7.1%) patients were granulocytopenic (ANC ≤100/μl). Nineteen (9.8%) had undergone marrow transplantation, 26 (13.5%) had a hematologic malignancy and 129 (66.5) had non-hematologic cancer. Candida isolates (216) were collected form 210 specimens. Fifty-three (27.5%) patients died; 25 (19.4%) with solid tumors, compared to 16 (61.5%) with hematological malignancy, and 11 (57.9%) BMT recipients (P < 0.001). No deaths were seen in patients with AIDS, and one (7.7 %) in a patient with a benign condition (P < 0.001). Twenty-six (29.2%) patients with respiratory tract, 13 (23.2%) with gastrointestinal tract, and three (14.3%) with genitourinary tract colonization died. In patients with multiple-site colonization, mortality was significantly higher (45.5%) (P < 0.05). Mortality was higher in patients with C. glabrata (52.9 %) and C. krusei (75%) colonization than with C. albicans (24.1%) (P < 0.025). This study shows that patients with hematologic cancer and recipients of marrow transplant with Candida colonization of multiple body sites, and colonization with C. glabata or C. krusei have poor survival.
Keywords: adult; cancer survival; controlled study; treatment outcome; aged; survival analysis; major clinical study; nonhuman; solid tumor; cancer patient; prospective study; prospective studies; neoplasms; cohort studies; cancer mortality; survival time; hematologic malignancy; hematologic neoplasms; evaluation; organ specificity; hospital patient; new york city; acquired immune deficiency syndrome; yeast; immunocompromised host; bone marrow transplantation; candidiasis; candida albicans; respiratory tract infection; cross infection; granulocytopenia; colonization; recipient; aids-related opportunistic infections; candida; gastrointestinal infection; urogenital tract infection; fungus isolation; agranulocytosis; hematological malignancy; candida glabrata; candida krusei; humans; prognosis; human; male; female; priority journal; article
Journal Title: Bone Marrow Transplantation
Volume: 30
Issue: 12
ISSN: 0268-3369
Publisher: Nature Publishing Group  
Date Published: 2002-12-02
Start Page: 931
End Page: 935
Language: English
DOI: 10.1038/sj.bmt.1703732
PUBMED: 12476287
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 14 November 2014 -- Source: Scopus
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MSK Authors
  1. Amar Safdar
    20 Safdar