title: Candida albicans versus non-albicans bloodstream infections: the comparison of risk factors and outcome.
abstract: BACKGROUND
  Candidemia caused by non-albicans Candida spp. is of special concern because of its high drug resistance and increase in prevalence. In clinical practice, early identification of non-albicans candidemia is crucial. We investigated the outcome in patients with candidemia caused by Candida albicans and Candida non-albicans.
  
  
  METHODS
  We retrospectively evaluated candidemic patients from October 2007 to July 2009. Underlying diseases, predisposing factors, laboratory data, and outcome were analyzed.
  
  
  RESULTS
  One hundred and eight patients of candidemia were enrolled. Candida albicans and non-albicans spp. were responsible for 56.5% (61 of 108) and 43.5% (47 of 108) of candidemia cases, respectively. Among patients with non-albicans candidemia, significantly more patients had neutropenia (p=0.001) and less patients had candiduria (p=0.001) and intensive care unit stay (p=0.002) in comparison with those with C albicans candidemia. All-cause Day 7 mortality was high in both C albicans and non-albicans spp. candidemia [44.3% (27 of 61) vs. 29.8% (14 of 47)]. Multivariate analysis revealed that poor renal function (odds ratio, 1.035; 95% confidence interval, 1.001-1.071; p=0.04) and shock (odds ratio, 19.4; 95% confidence interval, 2.53-149.5; p=0.004) are independent risk factors for fatal candidemia.
  
  
  CONCLUSIONS
  The outcome of candidemia was poor. The identified risk factors may help us to differentiate fatal candidemia in early infection.
authors.affiliation: Department of Internal Medicine, Song-Shan Armed Forces General Hospital, Taipei, Taiwan.
authors.forename: Hung-Wei
authors.initials: HW
authors.lastname: Chi
authors.forename: Ya-Sung
authors.initials: YS
authors.lastname: Yang
authors.forename: Shi-Ta
authors.initials: ST
authors.lastname: Shang
authors.forename: Ke-Hung
authors.initials: KH
authors.lastname: Chen
authors.forename: Kuo-Ming
authors.initials: KM
authors.lastname: Yeh
authors.forename: Feng-Yee
authors.initials: FY
authors.lastname: Chang
authors.forename: Jung-Chung
authors.initials: JC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use*; D002175:Candida / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification* / Q000472:pathogenicity; D058387:Candidemia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents