Comparison of albicans vs. non-albicans candidemia in French intensive care units.
BACKGROUND
Candidemia raises numerous therapeutic issues for intensive care physicians. Epidemiological data that could guide the choice of initial therapy are still required. This analysis sought to compare the characteristics of intensive care unit (ICU) patients with candidemia due to non-albicans Candida species with those of ICU patients with candidemia due to Candida albicans.


METHODS
A prospective, observational, multicenter, French study was conducted from October 2005 to May 2006. Patients exhibiting candidemia developed during ICU stay and exclusively due either to one or more non-albicans Candida species or to C. albicans were selected. The data collected included patient characteristics on ICU admission and at the onset of candidemia.


RESULTS
Among the 136 patients analyzed, 78 (57.4%) had candidemia caused by C. albicans. These patients had earlier onset of infection (11.1 +/- 14.2 days after ICU admission vs. 17.4 +/- 17.7, p = 0.02), higher severity scores on ICU admission (SOFA: 10.4 +/- 4.7 vs. 8.6 +/- 4.6, p = 0.03; SAPS II: 57.4 +/- 22.8 vs. 48.7 +/- 15.5, P = 0.015), and were less often neutropenic (2.6% vs. 12%, p = 0.04) than patients with candidemia due to non-albicans Candida species.


CONCLUSIONS
Although patients infected with Candida albicans differed from patients infected with non-albicans Candida species for a few characteristics, no clinical factor appeared pertinent enough to guide the choice of empirical antifungal therapy in ICU.
Leroy
Olivier
O
Service de Réanimation Médicale et des Maladies Infectieuses, Centre Hospitalier Gustave Dron, 135 rue du Président Coty, 59208 Tourcoing, France. oleroy@ch-tourcoing.fr
Mira
Jean-Paul
JP
Montravers
Philippe
P
Gangneux
Jean-Pierre
JP
Lortholary
Olivier
O
D000368:Aged; D002176:Candida albicans / Q000302:isolation & purification*; D058387:Candidemia / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005602:France; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000503:physiopathology; D011446:Prospective Studies; D012720:Severity of Illness Index