Risk Factors and Epidemiology of Candidemia by Candida guilliermondii

Ref ID: 18763

Author:

Y. Yamagishi, MD, PhD – Associate Professor, H. Mikamo, MD, PhD – Professor;

Author address:

Aichi Med. Univ., Aichi, Japan.

Full conference title:

52nd Annual ICAAC

Date: 9 September 2014

Abstract:

Background: C.guilliermondii is an uncommon isolate throughout most of the world. Limited observations are discussed in the literature concerning the epidemiology, echological niches and frequency of occurrence in the clinical and environmental settings of C. guilliermondii over the years. Previous reports have reported that C. guilliermondii has been mostly collected within cancer, hematology wards and dermatology wards. Methods: We investigated the comorbidities and risk factors of C. guilliermondii-associated candidemia in Japanese 10 hospitals between 2007 and 2011.Antifungal susceptibility tests of C. guilliermondii for amphotericin B (AMB), flucytosine (FCY), fluconazole (FLC),voriconazole (VOR), micafungin (MCA)and caspofungin (CAS) were performed by broth-microdilution test. Results: There have been 38 episodes of C. guilliermondii candidemia. The number of C. guilliermondii candemiain 2007, 2008, 2009, 2010 and 2011 has been going up year by year, 3, 5, 8, 9 and 13, respectively. Major risk factors of C. guilliermondii candidemia and the odds ratios were as follows; solid tumors, prior treatments by antibiotics within2 weeks, long-term (over 2 weeks) antifungals, intravascular catheters and dental devices, total parenteral nutrition and proton pump inhibitor use and 7.8, 43.6, 1.9, 7.8, 4.7 and 4.7, respectively. As for antifungal susceptibility, sensitivity rates of C. guilliermondii against FLC(MIC 8 or less), VOR(MIC 1 or less), AMB(MIC 1 or less), MCA (MIC 2 or less) and CAS(MIC 2 or less) were 76%, 92%, 100%, 61% and 61%, respectively. Conclusions: Although C. guilliermondii has been rare causative pathogen in candidemia, the isolation rate is going up among patients with solid tumors and prior treatments by antibiotics within 2 weeks. C. guilliermondii appears as constitutively less susceptible to azoles and echinocandins than other yeast-like fungi, so that the emergence of such pathogen in the clinical settings would be of concern, and earlier AMB use for C. gulliermondii therapy might be useful in clinical practice.

Abstract Number: M-325

Conference Poster: y

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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