Epidemiological and mycological characteristics of candidemia in patients with hematological malignancies attending a tertiary-care center in India

Dewan, Eshani; Biswas, Debasis; Kakati, Barnali; Verma, Shilp; Kotwal, Aarti; Oberoi, Aroma

doi:10.1016/j.hemonc.2015.06.006

Cited by 25 publications

(16 citation statements)

References 32 publications

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“…Candidemia is a leading cause of nosocomial bloodstream infections[ 1 , 2 ] and has a high attributable mortality[ 3 – 6 ]. Most series have addressed the characteristics and management of the disease in onco-hematological[ 7 – 9 ] or critically ill patients[ 10 – 20 ], although in recent years, attention has shifted towards episodes of candidemia in internal medicine departments[ 21 – 25 ].…”

Section: Introductionmentioning

confidence: 99%

Candidemia in non-ICU surgical wards: Comparison with medical wards

et al. 2017

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Candidemia acquired outside critical care or hematological areas has received much attention in recent years; however, data on candidemia in surgical departments are very scarce. Our objectives were to describe episodes of candidemia diagnosed in surgical wards and to compare them with episodes occurring in medical wards. We performed a post hoc analysis of a prospective, multicenter study implemented in Spain during 2010–2011 (CANDIPOP project). Of the 752 episodes of candidemia, 369 (49.1%) occurred in patients admitted to surgical wards (165, 21.9%) or medical wards (204, 27.2%). Clinical characteristics associated with surgical patients were solid tumor as underlying disease, recent surgery, indwelling CVC, and parenteral nutrition. Candidemia was more commonly related to a CVC in the surgical than in the medical wards. The CVC was removed more frequently and early management was more appropriate within 48 hours of blood sampling in the surgical patients. Overall, 30-day mortality in the surgical departments was significantly lower than in medical wards (37.7% vs. 15.8%, p<0.001). Multivariate analysis revealed admission to a surgical ward and appropriate early management of candidemia as factors independently associated with a better outcome. We found that approximately 50% of episodes of candidemia occurred in non-hematological patients outside the ICU and that clinical outcome was better in patients admitted to surgical wards than in those hospitalized in medical wards. These findings can be explained by the lower severity of underlying disease, prompt administration of antifungal therapy, and central venous catheter removal.

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Section: Introductionmentioning

confidence: 99%

Candidemia in non-ICU surgical wards: Comparison with medical wards

et al. 2017

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“…Invasive fungal disease is more likely to develop during the active stage of SLE. Although this patient was not at the active stage of SLE, long-lasting leukopenia caused by SLE induced bonemarrow failure and the resulting immune impairment might have contributed to the dissemination of candidemia [19][20][21]. Furthermore, leukopenia is a risk factor for candidemia caused by non-albicans Candida species compared with C. albicans [22,23].…”

Section: Discussionmentioning

confidence: 99%

Case report: nosocomial fungemia caused by Candida diddensiae

et al. 2020

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Background: Candida diddensiae, a yeast found in olive oil, is considered non-pathogenic to humans. Here, we describe the first case of fungemia caused by C. diddensiae in a hospitalized patient with underlying diseases. Case presentation: A 62-year-old woman was admitted because of multiple contusions due to repeated falls and generalized weakness. She presented with chronic leukopenia due to systemic lupus erythematosus, and multiple cranial nerve neuropathies due to a recurring chordoma. She was given a lipid emulsion containing total parenteral nutrition (TPN) starting on the day of admission. Broad-spectrum antibiotics had been administered during her last hospital stay and from day 8 of this hospitalization. However, no central venous catheter was used during this hospital stay. Blood cultures obtained on hospital days 17, 23, and 24 yielded the same yeast, which was identified as C. diddensiae via sequence analyses of the internal transcribed spacer region and D1/D2 regions of the 26S ribosomal DNA of the rRNA gene. In vitro susceptibility testing showed that the minimum inhibitory concentration of fluconazole for all isolates was 8 μg/mL. On day 23, TPN was discontinued and fluconazole therapy was started. Blood cultures obtained on day 26 were negative. The fluconazole therapy was replaced with micafungin on day 26 and the patient exhibited improvements. Conclusion: The use of lipid TPN may potentially contribute to the occurrence of nosocomial fungemia by C. diddensiae, an unusual Candida species.

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“…Candidemia and IFIs are major complications in patients with HMs who develop prolonged and severe neutropenia. Additionally, IFIs are difficult to diagnose in these severely immunocompromised patients [88][89][90][91]. In patients with MM prior to the introduction of novel therapies, IFIs were encountered in patients treated with traditional intensive cytotoxic chemotherapeutic regimens and mortality rates due to IFIs were reaching 60% [91].…”

Section: Fungal Infections In MMmentioning

confidence: 99%

“…Empirical antifungal agents are recommended in patients with HMs having neutropenia and persistent or recurrent fever despite appropriate antibiotic therapy [88]. In patients with candidemia or invasive infection caused by Candida species, echinocandins such as caspofungin, liposomal amphotericin-B, and voriconazole are the treatments of choice, while voriconazole is the treatment of choice for IFIs caused by Aspergillus species [67,89,90,92]. However, fluconazole is still the most common antifungal agent used for prophylaxis in HR patients and in recipients of HSCT [91,92].…”

Section: Fungal Infections In MMmentioning

confidence: 99%

Infections in Patients with Multiple Myeloma in the Era of Novel Agents and Stem Cell Therapies

Al-Jasser¹,

Al-Anazi²

2019

Update on Multiple Myeloma

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Multiple myeloma is a common hematologic malignancy that is associated with reduced cellular as well as humoral immunity ultimately causing various infectious complications. The recent advances in the management of myeloma have led not only to prolonged survival but also to shifts in the incidence as well as the spectrum of infections encountered. This book chapter will be an updated review on the infectious complications in patients with multiple myeloma in the era of novel agents, stem cell therapies, and monoclonal antibodies. It will cover causes of immunosuppression, timing, and types as well as management of the various infections reported with various therapeutic modalities that are currently utilized in the management of myeloma patients.

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Epidemiological and mycological characteristics of candidemia in patients with hematological malignancies attending a tertiary-care center in India

Cited by 25 publications

References 32 publications

Candidemia in non-ICU surgical wards: Comparison with medical wards

Candidemia in non-ICU surgical wards: Comparison with medical wards

Case report: nosocomial fungemia caused by Candida diddensiae

Infections in Patients with Multiple Myeloma in the Era of Novel Agents and Stem Cell Therapies

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