title: Lysis-centrifugation blood cultures in the detection of tissue-proven invasive candidiasis. Disseminated versus single-organ infection.
abstract: Several studies have demonstrated significantly higher frequency and more rapid detection of candidemia with blood culture methods performed by lysis-centrifugation (LC) in comparison with other techniques. Little is known, however, about the ability of LC blood culture methods to detect tissue-proven invasive candidiasis. We therefore investigated the sensitivity of LC blood cultures in the detection of tissue-proven invasive candidiasis. Between 1985 and 1991, invasive candidiasis was detected in 41 (5.1%) of 803 autopsies at the Clinical Center of the National Institutes of Health (Bethesda, MD, USA). Cases were classified as single-organ (SO) candidiasis (n = 20) and as disseminated candidiasis (DI) (n = 21). Patients with DI were more likely than those with SO to have a hematologic malignancy (71% vs 15%, P < 0.001) and to have gastrointestinal mucosal candidiasis (76% vs 25%, P = 0.003). LC detected fungemia in 16 (43%) of all 37 cases with blood cultures. When analyzed by classification, Candida spp. were isolated from blood in 11 (58%) of 19 patients with DI and in five (28%) of 18 patients with SO (P = 0.13). When analyzed by number of organs infected, blood cultures were positive in seven (78%) of nine patients with > 3 organs infected by Candida in comparison to five (28%) of 18 patients with one organ infected (P = 0.024). The mean recovery time for Candida in blood cultures was 2.6 days in DI and 3.2 days in SO (P = 0.017). There was no difference in colonies of organisms per LC tube between patients with DI and those with SO.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Infectious Diseases Section, National Cancer Institute, Bethesda, MD 20892.
authors.forename: J
authors.initials: J
authors.lastname: Berenguer
authors.forename: M
authors.initials: M
authors.lastname: Buck
authors.forename: F
authors.initials: F
authors.lastname: Witebsky
authors.forename: F
authors.initials: F
authors.lastname: Stock
authors.forename: P A
authors.initials: PA
authors.lastname: Pizzo
authors.forename: T J
authors.initials: TJ
authors.lastname: Walsh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002177:Candidiasis / Q000175:diagnosis*; D002498:Centrifugation; D016009:Chi-Square Distribution; D015169:Colony Count, Microbial; D003470:Culture Media; D004064:Digestive System / Q000382:microbiology*; D005260:Female; D016469:Fungemia / Q000175:diagnosis*; D006801:Humans; D007668:Kidney / Q000382:microbiology; D008168:Lung / Q000382:microbiology; D008172:Lung Diseases, Fungal / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
chemical_list: D003470:Culture Media