A prospective cohort study evaluating the prognostic impact of clinical characteristics and comorbid conditions of hospitalized adult and pediatric cancer patients with candidemia

Abstract

The purpose of this study was to describe the clinical aspects of the epidemiology of candidemia and compare the prognostic impact of potential risk factors and the microbiology data of adults and children with cancer. A prospective cohort study enrolling 99 adults and 130 children with candidemia at a tertiary oncology care center in Brazil was undertaken. A total of 229 episodes were analyzed. The overall mortality was higher among adults than in children (37.4% vs. 7.7%, respectively). Univariate analysis revealed significant differences in the risk factors associated with death between both groups. Mortality was similar following fungemia with Candida albicans and all C. non-albicans species. However, significant differences in the interspecies distribution and death rates were observed, mainly among C. glabrata, krusei, and tropicalis species. Multivariate analysis showed comorbidities and neutropenia to be independently associated with mortality in adults, while in children, only comorbidities negatively affected the outcome. Comorbidities were the most important independent prognostic factor in both groups. The inclusion of detailed information about pre-existent illnesses might have a real benefit in studies of candidemia outcome.

Multilocus Microsatellite Markers for Molecular Typing of Candida glabrata : Application to Analysis of Genetic Relationships between Bloodstream and Digestive System Isolates

“…Reasons for this change in species distribution remain uncertain but may be partially due to the natural resistance of C. glabrata to azole derivates, widely used since the 1980s (6,10,26). This lower susceptibility of C. glabrata to azoles (2,23,38) and delayed initiation of therapy due to delayed diagnosis (2,20,35) may explain in part why the prognosis for C. glabrata candidemia is worse than that for C. albicans candidemia (7,18,41,51).…”

Pediatrik Orbital ve Periorbital Selülitli Hastaların Değerlendirilmesi

“…İnvaziv Candida enfeksiyonlarında en sık izole edilen türün Candida albicans ikinci sırada ise C.parapsilosis olduğu bilinmektedir [3][4][5][6][7][8][9] . Bizim çalışmamızda C.albicans (%55.1) en sık izole edilen Candida türü iken C.parapsilosis (%27.5) ikinci en sık izole edilen Candida türü idi.…”

Ocorrência e Perfil de Suscetibilidade de Candida sp em hemoculturas de um hospital universitário

“…Em geral, em estudos comparativos, a prevalência tem sido do gênero masculino, inclusive em pacientes pediátri-cos. 15 BASSETTI et al, também confirmam a presente casuística, apesar de não haverem diferenças clínicas consideráveis para estes gêneros. 16 Outro fato que deve ser levado em consideração é o aparecimento de novas espécies de Candida, estas que, uma vez oportunistas, são praticamente impossíveis de serem detectadas no começo da manifestação.…”