title: Fungemia caused by Candida species and Torulopsis glabrata in the hospitalized patient: frequency, characteristics, and evaluation of factors influencing outcome.
abstract: We reviewed 135 cases of candidemia occurring between 1983 and 1986 to examine oncologic and nononcologic populations and assess factors for survival. Candida albicans was the most common species (51%); Candida tropicalis occurred most frequently in leukemia patients (57%), whereas Candida parapsilosis and Torulopsis glabrata were associated with solid tumors and nononcologic diseases. Risk factors identified were: preceding surgery, antibiotics, cannulas, and steroids in solid tumor and nononcologic diseases; and chemotherapy and neutropenia with hematologic malignancies. Even transient cannula-associated candidemia was not a benign process. Intravenous cannulas were common portals of entry (39%) in debilitated patients without cancer (59%) and were associated with high mortality (55%). Overall mortality was 59%, candidemia directly contributing to death in 75% of cases. In patients with candidemia, failure to initiate therapy with amphotericin B had a negative influence on outcome, whereas analysis of the entire group identified severity of underlying illness as the dominant cofactor influencing outcome.
authors.affiliation: Department of Medicine, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: S V
authors.initials: SV
authors.lastname: Komshian
authors.forename: A K
authors.initials: AK
authors.lastname: Uwaydah
authors.forename: J D
authors.initials: JD
authors.lastname: Sobel
authors.forename: L R
authors.initials: LR
authors.lastname: Crane
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D002408:Catheters, Indwelling; D003428:Cross Infection / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007938:Leukemia / Q000150:complications; D008223:Lymphoma / Q000150:complications; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D009503:Neutropenia / Q000150:complications; D011183:Postoperative Complications / Q000097:blood; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology*
chemical_list: D000935:Antifungal Agents