Hematogenous infections due to Candida parapsilosis: Changing trends in fungemic patients at a comprehensive cancer center during the last four decades Journal Article
| Authors: | Safdar, A.; Perlin, D. S.; Armstrong, D. |
| Article Title: | Hematogenous infections due to Candida parapsilosis: Changing trends in fungemic patients at a comprehensive cancer center during the last four decades |
| Abstract: | This study was performed to evaluate trends in species distribution in patients' with hematogenous candidiasis at a comprehensive cancer center. The results of a retrospective analysis from January 1, 1993 to December 31, 1998 were compared with prior reports from Memorial Sloan-Kettering Cancer Center in the last forty years. In 570 total episodes since 1974, 43.9% were due to Candida albicans. During 1990's, C. parapsilosis emerged as the most frequent yeast species in the non-C. albicans group (36.1% during 1993-1998 from 20.9% 1974-1982; p < 0.01). An increase in C. krusei from 5.9% (1974-1982) to 10.5% during the recent six years (1993-1998) was also noticed. The proportion of C. tropicalis among non-albicans fungemia during 1974-1982 was 42.8%, whereas in 1993 to 1998 a marked decline in C. tropicalis hematogenous infection was observed (27.8%; p < 0.01). During 1998, the incidence of candidemia declined from 7.1% (1972-1973) and 6.5% (1982) to 3.4% (p < 0.01), and improved survival among fungemic patients (33% mortality in 1998; 77.3% during 1974-1982; p < 0.001) was encouraging. The increase in C. parapsilosis bloodstream invasion during 1990's was associated with a significant reduction in the endogenous non-albicans Candida tropicalis infection that probably resulted in part due to the common prophylaxis, and/or preemptive fluconazole given routinely in high-risk patients undergoing treatment for cancer. The widespread use of extraneous implantable and/or semi-implantable indwelling intra-vascular devices may also have played an important role in promoting (exogenous) C. parapsilosis infection. This study emphasizes the importance of periodic evaluation of candidemia, especially at centers caring for patients at risk. © 2002 Elsevier Science Inc. All rights reserved. |
| Keywords: | survival; adult; cancer chemotherapy; controlled study; aged; middle aged; implant; survival rate; retrospective studies; major clinical study; mortality; prospective studies; neoplasms; incidence; drug resistance; risk assessment; cancer center; blood; severity of illness index; evaluation; prophylaxis; oncology service, hospital; forecasting; new york city; high risk population; yeast; hospital infection; infection prevention; immunocompromised host; fluconazole; candidiasis; infection risk; candida albicans; opportunistic infections; candidemia; candida; microbial sensitivity tests; antibiotics, antifungal; candida glabrata; candida krusei; candida parapsilosis; candida tropicalis; fungemia; cancer; humans; human; male; female; priority journal; article; changing trends |
| Journal Title: | Diagnostic Microbiology and Infectious Disease |
| Volume: | 44 |
| Issue: | 1 |
| ISSN: | 0732-8893 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2002-09-01 |
| Start Page: | 11 |
| End Page: | 16 |
| Language: | English |
| DOI: | 10.1016/s0732-8893(02)00423-6 |
| PUBMED: | 12376025 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 14 November 2014 -- Source: Scopus |
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