Clinical Characteristics Of Candidemia In Adults With Hematological Malignancy And Antimicrobial Susceptibilities Of The Isolates At A Medical Center In Taiwan, 2001-2010

Ref ID: 18783

Author:

H. Y. Tsai, MD (Doctor of Medicine) – Infection specialist1,2, Chien-Yuan Chen, Shang-Yi Huang, Woei Tsay, Ming Yao, Jih-Luh Tang, Bo-Sheng Ko, Wen-Chien Chou, Hwei-Fang Tien, Po-Ren Hsueh;

Author address:

1Far Eastern Mem. Hosp., New Taipei City, Taiwan, 2Far Eastern Mem. Hosp., New Taipei city, Taiwan.

Full conference title:

52nd Annual ICAAC

Date: 9 September 2014

Abstract:

Background: Few studies have investigated the clinical manifestations and outcome of candidemia in patients with hematological malignancies. Methods: We retrospectively analyzed the patient presented with candidemia in adult patients with hematological malignancies during the period 2001-1 to 2010-12 at the NTUH. Susceptibility of Candida species to nine antifungal agents was determined using the broth microdilution method. Interpretive criteria for susceptibility followed the MIC breakpoints of Candida species recommended by the CLSI (M27-S3) and the EUCAST-2012. Results: A total of 154 episodes of candidemia were noted in 111 of 2,574 patients with hematological malignancies. Patients with acute lymphoblastic leukemia (ALL) had a significantly higher rate of candidemia than patients with other hematological malignancies (Odds ratio, 2.69, p<0.001). Candida tropicalis was the most common Candida species (n=52, 47%), followed by C. albicans (n=35, 32%), C. parapsilosis (n=14, 13%). Multivariate analysis revealed that shock (p<0.001), allogeneic transplantation (p=0.033), and elderly (age, ≥ 60 years, p=0.041) were independent prognostic factors of 30-day overall survival. A total of 105 non-duplicate blood isolates of Candida species (84 isolates from 82 patients without persistent candidemia and 21 isolates from 21 patients with persistent candidemia) were evaluated for in vitro susceptibility. Fluconazole, voriconazole and posaconazole resistance were found in 8%, 8% and 38% of Candida isolates, respectively.All Candida isolates were susceptible to capsofungin and 2 (14%) of the 14 isolates of C. parapsilosis were not susceptible to micafungin or anidulafungin. Conclusions: patients with ALL are at higher risk of developing candidemia than patients with other hematological malignancies. Shock, allogeneic transplantation, and elderly, are independent predictors of outcome in patients with hematological malignancy and candidemia.

Abstract Number: M-1669

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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