Retrospective analysis of mortality and Candida isolates of 75 patients with candidemia: a single hospital experience

Figures & data

Table 1 Characteristics of patients with candidemia

Characteristics	N	%
Number of cases	75
Age (range)	62.1 (5–94)
Sex (male)	51	68
Death within 30 days of candidemia diagnosis	20	26.6
Presence of CVC	69	92
Immunosuppressive therapy	30	40
Intensive care unit admission	7	9.3
Total parenteral nutrition	58	77.3
Mechanical ventilation	7	9.3
Renal failure	6	8
Liver failure	20	26.6
Low serum albumin (<2.5 mg/dl)	68	90.6
Organ transplantation	7	9.3
History of Candida colonization	7	9.3
Surgery	20	26.6
Neutropenia	6	8
Malignancy	41	54.6
Lung disease	14	18.6
Diabetes mellitus	16	21.3
Diagnosis of and treatment for candidemia
Two sets of blood cultures	54	72
Examination of serum β-D glucan	53	70.6
Diagnosis of endophthalmitis due to Candida spp.	33	44
Removal of CVC	49	65.3
Antifungal agents
Fosfluconazole	28	37.3
Micafungin	34	45.3
Voriconazole	2	2.6
Liposomal amphotericin B	7	9.3
Itraconazole	2	2.6

Abbreviation: CVC, central venous catheter.

Table 2 Comparison of various parameters among survivors and non-survivors

	Survivors (%)	Non-survivors (%)	P-value
Clinical demographics
Number of cases	55	20
Age*	59.1±20.6	70.5±11.5	0.03
Sex (male)	39	12	0.37
Presence of CVC	52 (94.5)	17 (85)	0.33
Immunosuppressive therapy	21 (38.1)	9 (45)	0.59
Intensive care unit admission	5 (9.1)	2 (10)	0.9
Total parenteral nutrition	43 (78.1)	15 (75)	0.76
Mechanical ventilation	4 (7.3)	3 (15)	0.37
Renal failure	4 (7.3)	2 (10)	0.7
Liver failure	12 (21.8)	8 (40)	0.11
Low albumin (<2.5 mg/dl)	49 (89.0)	19 (95)	0.43
Organ transplantation	4 (7.3)	3 (15)	0.3
History of Candida colonization	4 (7.3)	3 (15)	0.37
Surgery	16 (29.1)	4 (20)	0.56
Neutropenia	3 (5.5)	3 (15)	0.18
Malignancy	32 (58.1)	9 (45)	0.31
Lung disease*	7 (12.7)	7 (35)	0.028
Diabetes mellitus	11 (20)	5 (25)	0.64
Treatment for candidemia
Removal of CVC*	44 (80)	5 (25)	<0.01
Fosfluconazole	21 (38.1)	7 (35)	0.8
Micafungin	27 (49.0)	7 (35)	0.27
Liposomal amphotericin B	5 (9.0)	2 (10)	0.9
Candida spp.
Candida albicans*	16 (29.0)	12 (60)	0.023
Candida parapsilosis*	22 (40)	1 (5)	<0.01
Candida guilliermondii	13 (23.6)	3 (15)	0.51
Resistance to fluconazole	4 (7.2)	4 (20)	0.11
Resistance to micafungin	4 (7.2)	1 (5)	0.72

Notes: Data are expressed as the mean ± standard deviation (SD; min–max). Statistical analyses were performed using the χ² test or Mann–Whitney U test.

* Significant difference (P<0.05).

Abbreviation: CVC, central venous catheter.

Table 3 Risk factors for death within 30 days of being diagnosed with candidemia according to a stepwise regression analysis

Risk factors	Odds ratio	95% CI	P-value
Age	1.11	1.01–1.23	0.04
Removal of CVC	0.03	0.002–0.3	0.01
Lung disease	3.99	0.6–26.4	0.15
Candida albicans	6.2	0.4–96.7	0.19
Candida parapsilosis	0.12	0.005–2.9	0.19

Notes: A multivariate analysis was performed using a stepwise logistic regression model. Each factor was selected by a univariate analysis between survivors and non-survivors (P<0.05).

Abbreviations: CVC, central venous catheter; CI, confidence interval.

Table 4 Comparison of various parameters among younger and elderly patients with candidemia

	Younger patients (%)	Elderly patients (%)	P-value
Clinical demographics
Number of cases	33	42
Age*	44.1±14.4	76.3±7.2	<0.01
Sex (male)	22	29	0.82
Death within 30 days of candidemia diagnosis	6 (18.1)	14 (33.3)	0.14
Presence of CVC	31 (93.9)	38 (90.4)	0.58
Immunosuppressive therapy*	20 (60.6)	10 (23.8)	<0.01
Intensive care unit admission	2 (6.0)	5 (11.9)	0.45
Total parenteral nutrition	25 (75.7)	33 (78.5)	0.72
Mechanical ventilation	2 (6.0)	5 (11.9)	0.45
Renal failure	2 (6.0)	4 (9.5)	0.68
Liver failure	11 (33.3)	9 (21.4)	0.24
Low albumin (<2.5 mg/dl)	28 (84.8)	40 (95.2)	0.12
Organ transplantation*	7 (21.2)	0 (0)	<0.01
History of Candida colonization	5 (15.1)	2 (4.7)	0.12
Surgery	8 (24.2)	12 (28.5)	0.67
Neutropenia	5 (15.1)	1 (2.3)	0.08
Malignancy	18 (54.5)	23 (54.7)	0.98
Lung disease	5 (15.1)	9 (21.4)	0.48
Diabetes mellitus	6 (18.1)	10 (23.8)	0.58
Treatment for candidemia
Removal of CVC	23 (69.6)	26 (61.9)	0.48
Fosfluconazole	11 (33.3)	17 (40.4)	0.52
Micafungin	15 (45.4)	19 (45.2)	0.98
Liposomal amphotericin B	3 (9.0)	4 (9.5)	1
Candida species
Candida albicans	10 (30.3)	18 (42.8)	0.26
Candida parapsilosis	12 (36.3)	11 (26.1)	0.34
Candida guilliermondii	6 (18.1)	10 (23.8)	0.55
Resistance to fluconazole	5 (15.1)	3 (7.1)	0.29
Resistance to micafungin	3 (9.1)	2 (4.7)	0.64

Notes: Data are expressed as the mean ± standard deviation (SD; min–max). Statistical analyses were performed using the χ² test or Mann–Whitney U test.

* Significant difference (P<0.05).

Abbreviation: CVC, central venous catheter.