Table 2.
Comparisons of Candida parapsilosis bloodstream infections (BSIs) and Candida albicans and other Candida spp. BSIs in CGMH, 2005–2020.
| Candida parapsilosis BSIs (n = 95) | Candida albicans BSIs (n = 171) | Other Candida spp. BSIs (n = 99) | p-Value * | |
|---|---|---|---|---|
| Neonatal episodes | 33 (34.7) | 53 (31.0) | 29 (29.3) | 0.744 |
| Pediatric episodes | 62 (65.3) | 118 (69.0) | 70 (70.7) | |
| Source of candidemia ** | 0.526, 0.028 | |||
| Primary bloodstream infection (BSI) | 53 (55.8) | 103 (60.2) | 70 (70.7) | 0.517, 0.037 |
| Catheter-related BSI | 28 (29.5) | 38 (22.2) | 12 (12.1) | 0.236, 0.004 |
| Abdominal | 10 (10.5) | 15 (8.8) | 12 (12.1) | |
| Urological | 2 (2.1) | 6 (3.5) | 1 (1.0) | |
| Pulmonary | 2 (2.1) | 6 (3.5) | 1 (1.0) | |
| Meningitis | 0 (0) | 3 (1.8) | 3 (3.1) | |
| Clinical presentation | ||||
| Sepsis | 78 (82.1) | 140 (81.9) | 83 (83.8) | 0.918, 0.884 |
| Severe sepsis | 44 (46.3) | 64 (37.4) | 41 (41.4) | 0.457, 0.866 |
| Septic shock | 27 (27.3) | 50 (29.2) | 28 (28.3) | 0.982, 0.874 |
| Progressive and deteriorated ¶ | 22 (23.2) | 38 (22.2) | 12 (12.1) | 0.873, 0.082 |
| Disseminated candidiasis $ | 4 (4.2) | 10 (5.8) | 3 (3.0) | 0.461, 0.555 |
| Duration of candidemia (days), median (range) | 3.0 (1.0-32.0) | 3.0 (1.0–20.0) | 3.0 (1.0–30.0) | 0.068, 0.830 |
| Breakthrough candidemia | 17 (17.9) | 12 (7.0) | 18 (18.2) | 0.012, 0.846 |
| Predisposing risk factors # | ||||
| Receipt of systemic antibiotics & | 88 (92.6) | 158 (92.4) | 94 (94.9) | 1.000, 0.562 |
| Previous azole exposure & | 17 (17.9) | 13 (7.6) | 10 (10.1) | 0.015, 0.147 |
| Previous bacteremia & | 45 (47.3) | 80 (46.8) | 59 (59.6) | 1.000, 0.113 |
| Presence of CVC | 94 (98.9) | 162 (94.7) | 98 (99.0) | 0.102, 1.000 |
| Receipt of parenteral nutrition | 73 (76.8) | 109 (63.7) | 68 (68.7) | 0.029, 0.259 |
| Receipt of immunosuppressants | 10 (10.5) | 33 (19.3) | 27 (27.3) | 0.081, 0.003 |
| Artificial device other than CVC | 48 (50.5) | 75 (43.9) | 57 (57.6) | 0.307, 0.387 |
| Prior surgery & | 26 (27.4) | 52 (30.4) | 33 (33.3) | 0.578, 0.436 |
| Neutropenia (ANC < 0.5 × 103/μL) | 23 (24.2) | 35 (20.5) | 29 (29.3) | 0.536, 0.517 |
All data are expressed as case number (%), unless otherwise stated. * p-Values are comparisons between patients with C. parapsilosis BSIs and C. albicans BSIs, and those with C. parapsilosis BSIs and other Candida spp. BSIs. ** Source of candidemia was defined as the first sterile site to have a positive culture for the Candida species in the episode. ¶ Defined as candidemia episodes with more disseminated candidiasis and/or progressive multi-organ failure even after effective antifungal agents. # Indicated the presence of an underlying condition or risk factor at the onset of Candida BSI, and most episodes occurred in patients with >1 underlying condition or risk factor. & Within one month prior to the onset of invasive candidemia. $ Indicated positive Candida isolates recovered from more than two sterile sites in addition to primary bloodstream infection. CVC: central venous catheter; ANC: absolute neutrophil count.