Breakthrough candidemia in patients with cancer differs from de novo candidemia in host factors and Candida species but not intensity.
OBJECTIVE
To evaluate the risk factors associated with breakthrough candidemia in patients with cancer and to compare them with those of de novo candidemia in this patient population.


METHODS
Retrospective case series of 120 episodes of candidemia, 90 de novo and 30 breakthrough candidemias.


METHODS
University-affiliated, tertiary-care cancer center in Houston, Texas.


METHODS
All patients with cancer who acquired candidemia between January 1993 and December 1998 were included if they had non-catheter-related candidemia and information about quantitative blood cultures.


RESULTS
Although less frequent, breakthrough candidemia was seen more often in neutropenic patients with leukemia. The intensity of breakthrough candidemia was comparable to that of de novo candidemia. Most (70%) of the breakthrough candidemias were due to Candida glabrata or C. krusei.


CONCLUSIONS
In breakthrough candidemia, the same risk factors seen in de novo candidemia were encountered, although more frequently. C. glabrata and C. krusei are the leading causes of breakthrough candidemia in patients with cancer.
Kontoyiannis
Dimitrios P
DP
Department of Infectious Diseases, Infection Control & Employee Health, The University of Texas MD. Anderson Cancer Center, Houston 77030, USA.
Reddy
Bhavanandra T
BT
Hanna
Hend
H
Bodey
Gerald P
GP
Tarrand
Jeffrey
J
Raad
Issam I
II
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities; D002176:Candida albicans; D041221:Candida glabrata; D041022:Candida tropicalis; D002177:Candidiasis / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D016469:Fungemia / Q000453:epidemiology / Q000209:etiology*; D006785:Hospitals, University; D006801:Humans; D017053:Infection Control; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000097:blood / Q000150:complications; D009504:Neutrophils; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology