title: Antibiotics exposure, risk factors, and outcomes with Candida albicans and non-Candida albicans candidemia. Results from a multi-center study.
abstract: OBJECTIVE
  To define the differences in antibiotics exposure, risk factors, and outcome in hospitalized patients with Candida albicans (C. albicans) and non-C. albicans candidemia.
  
  
  METHODS
  This is a multi-center retrospective study of 132 patients with candidemia from 5 tertiary-care educational hospitals in Shandong, China conducted between January 2009 and June 2010. Fifty-six of 132 (42.4%) patients had candidemia due to C. albicans and 76/132 (57.6%) had non-C. albanians candidemia.
  
  
  RESULTS
  Patients with non-C. albicans candidemia received anti-anaerobic agents more often (23.7% versus 8.9%; p=0.027) and beta-lactam/beta-lactamase inhibitors less often (34.2% versus 51.8%; p=0.043) than those with C. albicans candidemia. Independent risk factors of non-C. albicans candidemia were prior anti-anaerobic and antifungal therapies and central venous catheter placement. Overall, 30-day mortality was higher for patients with C. albicans than non-C. albicans candidemia (50% versus 31.6%; p=0.032). Multivariate logistic regression analysis revealed that C. albicans candidemia, advanced age, and concomitant bacteremia were associated with death due to candidemia.
  
  
  CONCLUSIONS
  Patients who received anti-anaerobic or antifungal agents were likely to develop non-C. albicans candidemia. Candida albicans infection was associated with poorer prognosis. An awareness of these factors is needed to guide therapy and decrease the high mortality of candidemia.
authors.affiliation: Department of Critical Care Medicine, Qilu Hospital, Shandong University, Jinan, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.forename: Da-Wei
authors.initials: DW
authors.lastname: Wu
authors.forename: Hui
authors.initials: H
authors.lastname: Han
authors.forename: Jin-Feng
authors.initials: JF
authors.lastname: Yue
authors.forename: Fan
authors.initials: F
authors.lastname: Zhang
authors.forename: Ti-Chao
authors.initials: TC
authors.lastname: Shan
authors.forename: Hai-Peng
authors.initials: HP
authors.lastname: Guo
authors.forename: Mei
authors.initials: M
authors.lastname: Yin
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002177:Candidiasis / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents