Journal Article

The Epidemiology of Hematogenous Candidiasis Caused by Different <i>Candida</i> Species

Dima Abi-Said, Elias Anaissie, Omrum Uzun, Issam Raad, Helio Pinzcowski and Shahe Vartivarian

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 24, issue 6, pages 1122-1128
Published in print June 1997 | ISSN: 1058-4838
Published online June 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/513663
The Epidemiology of Hematogenous Candidiasis Caused by Different Candida Species

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The medical records of patients with hematogenous candidiasis at M. D. Anderson Cancer Center (Houston) between 1988 and 1992 were retrospectively reviewed. There were 491 episodes of infection (6 per 1,000 admissions), 79% of which occurred outside the intensive care unit setting. A significant decrease in incidence was observed among patients with leukemia over the study period, together with a relative decrease in Candida albicans and Candida tropicalis infections and an increase in Candida krusei and possibly Candida glabrata infections. In the multivariate analysis, fluconazole prophylaxis provided strong protection against the development of C. tropicalis infection (odds ratio [OR] = 0.08) and C. albicans infection (OR = 0.15), in comparison with protection against infections due to other species, but it was the single most important determinant for the relative increase in C. krusei (OR = 27.07) and C. glabrata (OR = 5.08) infections. In conclusion, there has been a substantial shift in the epidemiology of hematogenous candidiasis caused by different Candida species in recent years. Fluconazole appears to be playing a major role in this observed shift.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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