title: Clinical characteristics and risk factors of non-Candida fungaemia.
abstract: BACKGROUND
  The incidence of fungaemia has been increasing worldwide. It is important to distinguish non-Candida fungaemia from candidaemia because of their different antifungal susceptibilities. The aims of this study were to investigate the clinical characteristics of non-Candida fungaemia and identify the clinical factors that differentiate it from candidaemia.
  
  
  METHODS
  We investigated the clinical manifestations and mortality of non-Candida fungaemia in Kyoto University Hospital from 2004 to 2009.
  
  
  RESULTS
  There were 110 episodes of fungaemia during the study period. There were 11 renal replacement therapy episodes of fungaemia due to non-Candida yeasts (10.0%), including 6 episodes with Cryptococcus neoformans, 4 with Trichosporon asahii, and 1 with Kodamaea ohmeri, in addition to 99 episodes of candidaemia (90.0%). The presence of collagen disease [odds ratio (OR) 9.00; 95% confidence interval (CI) 1.58-51.4; P=0.01] or renal replacement therapy (OR 15.0; 95% CI 3.06-73.4; P<0.01) was significantly more common in non-Candida fungaemia patients than in candidaemia patients. Prior colonisation by the species may be a predictor of non-Candida fungaemia. Non-Candida fungaemia had a higher mortality than candidaemia (54.5% versus 21.2%, P=0.03).
  
  
  CONCLUSIONS
  Although Candida species frequently cause fungaemia, we should also be aware of non-Candida yeasts because of their high mortality, particularly among high-risk patients, such as those with collagen disease and those under renal replacement therapy. Prior colonisation by the causative organisms may be an important predictor of non-Candida fungaemia.
authors.affiliation: Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 6068507, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Shunji
authors.initials: S
authors.lastname: Takakura
authors.forename: Gou
authors.initials: G
authors.lastname: Hotta
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Matsumura
authors.forename: Aki
authors.initials: A
authors.lastname: Matsushima
authors.forename: Miki
authors.initials: M
authors.lastname: Nagao
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ito
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ichiyama
mesh_terms: D000368:Aged; D015897:Comorbidity; D005260:Female; D016469:Fungemia / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D003904:Mitosporic Fungi / Q000302:isolation & purification; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors