Clinical Characteristics of Candidemia Due to Candida parapsilosis with Serial Episodes: Insights from 5-Year Data Collection at a Tertiary Hospital in Korea
Abstract
:1. Introduction
2. Materials and Methods
Statistical Analysis
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Antifungal Agents | MIC (μg/mL) | No. (%) of Isolates * | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
0.01 | 0.02 | 0.03 | 0.06 | 0.12 | 0.25 | 0.5 | 1 | 2 | 4 | 8 | 16 | MIC Range | MIC50 | MIC90 | Resistant | Intermediate | |
Fluconazole | 7 | 5 | 23 | 25 | 6 | 2 * | 0.12–16 | 0.5 | 2 | 2 (2.9) | 0 (0.0) | ||||||
Voriconazole | 21 | 23 | 18 | 4 | 1 | 1 | 0.008–0.5 | 0.015 | 0.03 | 0 (0.0) | 1 (1.4) | ||||||
Posaconazole | 9 | 14 | 36 | 5 | 2 | 1 | 1 | 0.008–2 | 0.03 | 0.06 | N.A. | N.A. | |||||
Caspofungin | 7 | 1 | 3 | 6 | 18 | 27 | 6 | 0.008–1 | 0.25 | 0.5 | 0 (0.0) | 0 (0.0) | |||||
Micafungin | 7 | 1 | 2 | 9 | 22 | 25 | 2 | 0.008–2 | 0.5 | 1 | 0 (0.0) | 0 (0.0) | |||||
Anidulafungin | 7 | 1 | 5 | 12 | 27 | 15 | 1 | 0.015–2 | 0.5 | 1 | 0 (0.0) | 0 (0.0) | |||||
Amphotericin B | 1 | 26 | 20 | 19 | 2 | 0.06–1 | 0.25 | 0.5 | N.A. | N.A. | |||||||
5-FC | 2 | 66 | 0.03–0.06 | 0.06 | 0.06 | N.A. | N.A. |
Isolate | MIC (µg/mL) | ERG11 * | Microsatellite-Minisatellite Typing ** | Clinical Features | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
FLU/VOR/CAS/ANI/MICA | ACA | CP1 | CP4 | CP6 | Candidemia Episode | Age/Sex | Underlying Diagnosis | Previous Antifungal Therapy | Antifungal Therapy | CVC Use | Prognosis at 30-Day | ||
No. 1 | 16/0.5/0.12/0.06/0.015 | Y132F | 370/370 | 243/243 | 373/373 | 286/292 | Single | 73/M | Hypoxic brain injury | None | None | None | Survive |
No. 2 | 16/0.12/0.5/1/1 | K143R | 247/295 | 222/222 | 212/212 | 187/187 | Serial (0, 1, 3, 5, 7) | 57/M | Infective endocarditis | ANI (-4~0) | AMB (1~23), VOR (9~156), FLU (24~32) | Yes | Survive |
Characteristics | Total | Single Isolate | Serial Isolates | p-Value | |
---|---|---|---|---|---|
No. of cases | 68 | 35 | 33 | ||
Demographics | |||||
Age, years, median (IQR) | 68 (57.75–75) | 66 (55–76) | 73 (59–75) | ||
Male, No. (%) | 43 (63.2) | 21 (58.3) | 22 (66.7) | 0.475 | |
Underlying condition | |||||
Diabetes melitus, No. (%) | 10 (14.7) | 5 (14.3) | 5 (15.2) | 0.919 | |
Liver disease, No. (%) | 10 (14.7) | 1 (2.9) | 9 (27.3) | 0.004 | |
Moderate to severe chronic kidney disease, No. (%) | 7 (10.3) | 3 (8.6) | 4 (12.1) | 0.63 | |
Congestive heart failure, No. (%) | 8 (11.8) | 3 (8.6) | 5 (15.2) | 0.399 | |
Myocardial infarction, No. (%) | 11 (16.2) | 7 (20) | 4 (12.1) | 0.377 | |
Chronic obstructive pulmonary disease, No. (%) | 8 (11.8) | 3 (8.6) | 5 (15.2) | 0.399 | |
Peripheral vascular disease, No. (%) | 1 (1.5) | 1 (2.9) | 0 (0) | N.A. | |
Cerebro-vascular disease, No. (%) | 10 (14.7) | 6 (17.1) | 4 (12.1) | 0.558 | |
Dementia, No. (%) | 1 (1.5) | 0 (0) | 1 (3) | N.A. | |
Hemiplegia, No. (%) | 4 (5.9) | 3 (8.6) | 1 (3) | 0.331 | |
Peptic ulcer disease, No. (%) | 3 (4.4) | 2 (5.7) | 1 (3) | 0.59 | |
Connective tissue disease, No. (%) | 4 (5.9) | 2 (5.7) | 2 (6.1) | 0.951 | |
Solid tumor, No. (%) | 40 (58.8) | 21 (60) | 19 (57.6) | 0.839 | |
Leukemia, No. (%) | 2 (2.9) | 0 (0) | 2 (6.1) | N.A. | |
Lymphoma, No. (%) | 3 (4.4) | 2 (5.7) | 1 (3) | 0.59 | |
Vasopressors, No. (%) | 15 (22.1) | 4 (11.4) | 11 (33.3) | 0.029 | |
Acute renal failure, No. (%) | 9 (13.2) | 4 (11.4) | 5 (15.2) | 0.65 | |
Infective endocarditis, No. (%) | 5 (7.2) | 0 (0.0) | 4 (12.1) | N.A. | |
Clinical status at positive culture | |||||
Intensive care unit admission, No. (%) | 23 (33.8) | 8 (22.9) | 15 (45.5) | 0.049 | |
Total parenteral nutrition, No. (%) | 10 (14.7) | 3 (8.6) | 7 (21.2) | 0.141 | |
Prior surgery, No. (%) | 16 (23.5) | 7 (20) | 9 (27.3) | 0.479 | |
Severe sepsis, No. (%) | 22 (32.4) | 7 (20) | 15 (45.5) | 0.024 | |
Immunosuppressive therapy, No. (%) | 7 (10.3) | 5 (14.3) | 2 (6.1) | 0.264 | |
Neutropenia, No. (%) | 6 (8.8) | 2 (5.7) | 4 (12.1) | 0.351 | |
CVC use, No. (%) | 42 (61.8) | 16 (45.7) | 26 (78.8) | 0.005 | |
Early CVC removal, No. (%) | 22 (32.4) | 9 (56.3) | 13 (50) | 0.693 | |
CVC duration, days, median (IQR) | 3 (2–5.75) | 3 (2–6.75) | 3 (2–5.75) | 0.839 | |
Urine catheter, No. (%) | 8 (11.8) | 2 (5.7) | 6 (18.2) | 0.11 | |
Concommittant bacteremia, No. (%) | 21 (30.9) | 8 (22.9) | 13 (39.4) | 0.14 | |
Prognosis | |||||
30-day mortality, Death (%) | 12 (17.6) | 6 (17.1) | 6 (18.2) | 0.91 | |
Antifungal therapy | |||||
Any antifungal agent use, No. (%) | 57 (83.8) | 27 (77.1) | 30 (90.9) | 0.123 | |
Azoles | 37 (54.4) | 18 (51.4) | 19 (57.6) | 0.61 | |
Echinocandins | 41 (60.3) | 17 (48.6) | 24 (72.7) | 0.041 | |
Amphotericin B | 3 (4.4) | 0 (0) | 3 (9.1) | N.A. |
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Won, E.J.; Sung, H.; Kim, M.-N. Clinical Characteristics of Candidemia Due to Candida parapsilosis with Serial Episodes: Insights from 5-Year Data Collection at a Tertiary Hospital in Korea. J. Fungi 2024, 10, 624. https://doi.org/10.3390/jof10090624
Won EJ, Sung H, Kim M-N. Clinical Characteristics of Candidemia Due to Candida parapsilosis with Serial Episodes: Insights from 5-Year Data Collection at a Tertiary Hospital in Korea. Journal of Fungi. 2024; 10(9):624. https://doi.org/10.3390/jof10090624
Chicago/Turabian StyleWon, Eun Jeong, Heungsup Sung, and Mi-Na Kim. 2024. "Clinical Characteristics of Candidemia Due to Candida parapsilosis with Serial Episodes: Insights from 5-Year Data Collection at a Tertiary Hospital in Korea" Journal of Fungi 10, no. 9: 624. https://doi.org/10.3390/jof10090624