title: Associated clinical characteristics of patients with candidemia among different Candida species.
abstract: BACKGROUND
  The rising incidence of non-albicans Candida (NAC) infection has been associated with a potentially adverse outcome for patients with candidemia. However, categorizing various species causing candidemia into a single NAC group might lead to inappropriate conclusions due to heterogeneity in species. Thus we examined the associated factors among patients with candidemia caused by different species.
  
  
  METHODS
  This retrospective study was conducted at a tertiary medical center in Taiwan from 2006 to 2009. Mortality rate, demographic and clinical characteristics, albumin levels, and severity scores of acute illness of patients at the onset of candidemia were analyzed.
  
  
  RESULTS
  A total of 447 episodes among 418 patients were included for analysis. The overall 30-day crude mortality was 48.2%, with no significant difference between C. albicans and NAC candidemia, but apparently C. parapsilosis candidemia was associated with a lower mortality rate. Time to positivity for yeast was significantly different between species. Compared with infection involving C. albicans, more frequent use of total parenteral nutrition, lower Sequential Organ Failure Assessment score and higher albumin levels were observed for C. parapsilosis candidemia.
  
  
  CONCLUSIONS
  Identifying associated factors for each species may be a more effective approach than single NAC grouping. Time to positivity may be a hint for treatment guidance in candidemia. More frequent use of total parenteral nutrition and less virulent nature were noted for C. parapsilosis candidemia.
authors.affiliation: Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Liang-Yu
authors.initials: LY
authors.lastname: Chen
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Shu-Chen
authors.initials: SC
authors.lastname: Kuo
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Hau-Shin
authors.initials: HS
authors.lastname: Wu
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Su-Pen
authors.initials: SP
authors.lastname: Yang
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Division of Virology, Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Yu-Jiun
authors.initials: YJ
authors.lastname: Chan
authors.affiliation: Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Liang-Kung
authors.initials: LK
authors.lastname: Chen
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. Electronic address: fdwang@vghtpe.gov.tw.
authors.forename: Fu-Der
authors.initials: FD
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida / Q000145:classification* / Q000302:isolation & purification*; D058387:Candidemia / Q000382:microbiology* / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D012720:Severity of Illness Index; D016019:Survival Analysis; D013624:Taiwan; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D012709:Serum Albumin