Table 2.
Comparisons of monomicrobial Candida bloodstream infections (BSIs) and mixed Candida/bacterial BSIs in CGMH, 2005–2020.
| Overall Candida BSI (total n = 365) | Monomicrobial Candida BSIs (Total n = 330) |
Mixed Candida/Bacterial BSIs (Total n = 35) | p Value | |
|---|---|---|---|---|
| Neonatal episodes | 114 (31.2) | 106 (32.1) | 8 (22.9) | 0.338 |
| Pediatric episodes | 251 (68.8) | 224 (67.9) | 27 (77.1) | |
| Pathogens | 0.708 | |||
| Candida albicans | 171 (46.8) | 152 (46.1) | 19 (54.3) | |
| Candida parapsilosis | 95 (26.0) | 84 (25.5) | 11 (31.4) | |
| Candida tropicalis | 21 (5.8) | 21 (6.4) | 0 (0) | |
| Candida glabrata | 20 (5.5) | 18 (5.5) | 2 (5.7) | |
| Candida guilliermondii | 18 (4.9) | 18 (5.5) | 0 (0) | |
| Other Candida spp. | 40 (11.0) | 37 (11.2) | 3 (8.6) | |
| Source of candidemia * | 0.602 | |||
| Primary bloodstream infection (BSI) | 226 (61.9) | 200 (60.1) | 26 (74.3) | |
| Catheter-related BSI | 78 (21.4) | 72 (21.8) | 6 (17.1) | |
| Abdominal | 37 (10.1) | 35 (10.6) | 2 (5.7) | |
| Urological | 9 (2.5) | 9 (2.7) | 0 (0) | |
| Pulmonary | 9 (2.5) | 8 (2.4) | 1 (2.9) | |
| Meningitis | 6 (1.6) | 6 (1.8) | 0 (0) | |
| Clinical presentation | ||||
| Sepsis | 301 (82.5) | 272 (82.4) | 29 (82.9) | 0.982 |
| Severe sepsis | 149 (40.8) | 130 (39.4) | 19 (54.3) | 0.104 |
| Septic shock | 105 (28.8) | 90 (27.3) | 15 (42.9) | 0.075 |
| Progressive and deteriorated ¶ | 72 (19.7) | 62 (18.8) | 10 (28.6) | 0.181 |
| Disseminated candidiasis $ | 17 (4.7) | 15 (4.5) | 2 (5.7) | 0.389 |
| Duration of candidemia (days), median (range) |
4.0 (1.0–42.0) | 4.0 (1.0–36.0) | 4.0 (1.0–42.0) | 0.214 |
| Predisposing risk factors # | ||||
| Receipt of systemic antibiotics & | 340 (93.2) | 305 (92.4) | 35 (100.0) | 0.151 |
| Previous azole exposure & | 40 (11.0) | 36 (10.9) | 4 (11.4) | 0.925 |
| Previous bacteremia & | 184 (50.4) | 163 (49.4) | 21 (60.0) | 0.287 |
| Presence of CVC | 354 (97.0) | 321 (97.3) | 33 (94.3) | 0.285 |
| Receipt of parenteral nutrition | 250 (68.5) | 224 (67.9) | 26 (74.3) | 0.566 |
| Receipt of immunosuppressants | 70 (19.2) | 64 (19.1) | 6 (17.1) | 0.748 |
| Artificial device other than CVC | 180 (49.3) | 163 (49.4) | 17 (48.6) | 0.926 |
| Prior surgery & | 111 (30.4) | 105 (31.8) | 6 (17.1) | 0.117 |
| Neutropenia (ANC < 0.5 × 103/μL) | 87 (23.8) | 76 (23.0) | 11 (31.4) | 0.297 |
All data are expressed as case number (%), unless otherwise stated. * Source of candidemia was defined as the first sterile site to have 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. # Indicateds the presence of underlying condition or risk factor at onset of Candida BSI, and most episodes occurred in patients with >1 underlying conditions or risk factors. & Within one month prior to onset of invasive candidemia. $ Indicates positive Candida isolates recovered from more than two sterile sites, in addition to primary bloodstream infection.