Candida tropicalis bloodstream infection

Incidence, risk factors and outcome in a population-based surveillance

Mario Fernández-Ruiz, Mireia Puig-Asensio, Jesús Guinea, Benito Almirante, Belén Padilla, Manuel Almela, Ana Díaz-Martín, Jesús Rodríguez-Baño, Manuel Cuenca-Estrella, José María Aguado, Patricia Muñoz, José Ramón Paño Pardo, Julio García-Rodríguez, Carlos García Cerrada, Jesús Fortún, Pilar Martín, Elia Gómez, Pablo Ryan, Carolina Campelo, Ignacio de los Santos Gil & 54 others Ventura Buendía, Beatriz Perez Gorricho, Mercedes Alonso, Francisca Sanz Sanz, Paloma Merino, Fernando González Romo, Miguel Gorgolas, Ignacio Gadea, Juan Emilio Losa, Alberto Delgado-Iribarren, Antonio Ramos, Yolanda Romero, Isabel Sánchez Romero, Oscar Zaragoza, Jesús Rodriguez-Baño, Ana Isabel Suarez, Ana Loza, Ana Isabel Aller García, Estrella Martín-Mazuelos, Maite Ruiz Pérez de Pipaón, José Garnacho, Carlos Ortiz, Mónica Chávez, Fernando L. Maroto, Miguel Salavert, Javier Pemán, José Blanquer, David Navarro, Juan José Camarena, Rafael Zaragoza, Vicente Abril, Concepci ón Gimeno, Silvia Hernáez, Guillermo Ezpeleta, Elena Bereciartua, José L. Hernández Almaraz, Miguel Montejo, Rosa Ana Rivas, Rafael Ayarza, Ana Ma Planes, Isabel Ruiz Camps, José Mensa, Mercè Gurgui, Ferran Sánchez-Reus, Joaquin Martinez-Montauti, Montserrat Sierra, Juan Pablo Horcajada, Luisa Sorli, Julià Gómez, Amadeu Gené, Mireia Urrea, Maricela Valerio, Francesc Puchades, Alessandra Mularoni

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective: To assess the current clinical features and determinants of outcome of Candida tropicalis bloodstream infection (BSI). Methods: A population-based surveillance on Candida BSI was conducted from May 2010 to April 2011 in 29 Spanish hospitals. Antifungal susceptibility testing (EUCAST methodology) was centrally performed. The characteristics and outcome of C. tropicalis BSI episodes were compared with those due to other species. Results: Fifty-nine out of 752 episodes (7.8%) were due to C. tropicalis (annual incidence: 0.62 cases per 100,000 population). Resistance to fluconazole and voriconazole was found in 23.2% and 26.8% of isolates. Breakthrough BSI occurred in 10.5% of episodes. Risk factors for C. tropicalis BSI were age (odds ratio [OR]: 1.01; P-value = 0.05), underlying leukaemia (OR: 4.77; P-value = 0.001) and chronic lung disease (OR: 2.62; P-value = 0.002). There were no differences in clinical failure (persistent BSI for ≥72 h after initiation of therapy and/or 30-day all-cause mortality) between C. tropicalis (39.6%) and non-C. tropicalis groups (45.6%). The appropriateness of antifungal therapy or the fluconazole MIC values had no significant impact on outcome, whereas early central venous catheter removal exerted a protective effect. Conclusions: C. tropicalis BSI was associated with advanced age, haematological malignancy and respiratory comorbidity. We found no correlation between the unexpectedly high resistance rate to azoles observed and outcome.

Original languageEnglish
Pages (from-to)385-394
Number of pages10
JournalJournal of Infection
Volume71
Issue number3
DOIs
Publication statusPublished - 2015

Fingerprint

Population Surveillance
Candida tropicalis
Incidence
Infection
Fluconazole
Odds Ratio
Azoles
Central Venous Catheters
Hematologic Neoplasms
Candida
Lung Diseases
Comorbidity
Leukemia
Chronic Disease
Mortality
Therapeutics

Keywords

  • Candida tropicalis bloodstream infection
  • Epidemiology
  • Minimum inhibitory concentration
  • Outcome
  • Treatment

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Candida tropicalis bloodstream infection : Incidence, risk factors and outcome in a population-based surveillance. / Fernández-Ruiz, Mario; Puig-Asensio, Mireia; Guinea, Jesús; Almirante, Benito; Padilla, Belén; Almela, Manuel; Díaz-Martín, Ana; Rodríguez-Baño, Jesús; Cuenca-Estrella, Manuel; Aguado, José María; Muñoz, Patricia; Paño Pardo, José Ramón; García-Rodríguez, Julio; Cerrada, Carlos García; Fortún, Jesús; Martín, Pilar; Gómez, Elia; Ryan, Pablo; Campelo, Carolina; Gil, Ignacio de los Santos; Buendía, Ventura; Gorricho, Beatriz Perez; Alonso, Mercedes; Sanz, Francisca Sanz; Merino, Paloma; Romo, Fernando González; Gorgolas, Miguel; Gadea, Ignacio; Losa, Juan Emilio; Delgado-Iribarren, Alberto; Ramos, Antonio; Romero, Yolanda; Romero, Isabel Sánchez; Zaragoza, Oscar; Rodriguez-Baño, Jesús; Suarez, Ana Isabel; Loza, Ana; Aller García, Ana Isabel; Martín-Mazuelos, Estrella; Pérez de Pipaón, Maite Ruiz; Garnacho, José; Ortiz, Carlos; Chávez, Mónica; Maroto, Fernando L.; Salavert, Miguel; Pemán, Javier; Blanquer, José; Navarro, David; Camarena, Juan José; Zaragoza, Rafael; Abril, Vicente; Gimeno, Concepci ón; Hernáez, Silvia; Ezpeleta, Guillermo; Bereciartua, Elena; Hernández Almaraz, José L.; Montejo, Miguel; Rivas, Rosa Ana; Ayarza, Rafael; Planes, Ana Ma; Camps, Isabel Ruiz; Mensa, José; Gurgui, Mercè; Sánchez-Reus, Ferran; Martinez-Montauti, Joaquin; Sierra, Montserrat; Horcajada, Juan Pablo; Sorli, Luisa; Gómez, Julià; Gené, Amadeu; Urrea, Mireia; Valerio, Maricela; Puchades, Francesc; Mularoni, Alessandra.

In: Journal of Infection, Vol. 71, No. 3, 2015, p. 385-394.

Research output: Contribution to journalArticle

Fernández-Ruiz, M, Puig-Asensio, M, Guinea, J, Almirante, B, Padilla, B, Almela, M, Díaz-Martín, A, Rodríguez-Baño, J, Cuenca-Estrella, M, Aguado, JM, Muñoz, P, Paño Pardo, JR, García-Rodríguez, J, Cerrada, CG, Fortún, J, Martín, P, Gómez, E, Ryan, P, Campelo, C, Gil, IDLS, Buendía, V, Gorricho, BP, Alonso, M, Sanz, FS, Merino, P, Romo, FG, Gorgolas, M, Gadea, I, Losa, JE, Delgado-Iribarren, A, Ramos, A, Romero, Y, Romero, IS, Zaragoza, O, Rodriguez-Baño, J, Suarez, AI, Loza, A, Aller García, AI, Martín-Mazuelos, E, Pérez de Pipaón, MR, Garnacho, J, Ortiz, C, Chávez, M, Maroto, FL, Salavert, M, Pemán, J, Blanquer, J, Navarro, D, Camarena, JJ, Zaragoza, R, Abril, V, Gimeno, CÓ, Hernáez, S, Ezpeleta, G, Bereciartua, E, Hernández Almaraz, JL, Montejo, M, Rivas, RA, Ayarza, R, Planes, AM, Camps, IR, Mensa, J, Gurgui, M, Sánchez-Reus, F, Martinez-Montauti, J, Sierra, M, Horcajada, JP, Sorli, L, Gómez, J, Gené, A, Urrea, M, Valerio, M, Puchades, F & Mularoni, A 2015, 'Candida tropicalis bloodstream infection: Incidence, risk factors and outcome in a population-based surveillance', Journal of Infection, vol. 71, no. 3, pp. 385-394. https://doi.org/10.1016/j.jinf.2015.05.009
Fernández-Ruiz, Mario ; Puig-Asensio, Mireia ; Guinea, Jesús ; Almirante, Benito ; Padilla, Belén ; Almela, Manuel ; Díaz-Martín, Ana ; Rodríguez-Baño, Jesús ; Cuenca-Estrella, Manuel ; Aguado, José María ; Muñoz, Patricia ; Paño Pardo, José Ramón ; García-Rodríguez, Julio ; Cerrada, Carlos García ; Fortún, Jesús ; Martín, Pilar ; Gómez, Elia ; Ryan, Pablo ; Campelo, Carolina ; Gil, Ignacio de los Santos ; Buendía, Ventura ; Gorricho, Beatriz Perez ; Alonso, Mercedes ; Sanz, Francisca Sanz ; Merino, Paloma ; Romo, Fernando González ; Gorgolas, Miguel ; Gadea, Ignacio ; Losa, Juan Emilio ; Delgado-Iribarren, Alberto ; Ramos, Antonio ; Romero, Yolanda ; Romero, Isabel Sánchez ; Zaragoza, Oscar ; Rodriguez-Baño, Jesús ; Suarez, Ana Isabel ; Loza, Ana ; Aller García, Ana Isabel ; Martín-Mazuelos, Estrella ; Pérez de Pipaón, Maite Ruiz ; Garnacho, José ; Ortiz, Carlos ; Chávez, Mónica ; Maroto, Fernando L. ; Salavert, Miguel ; Pemán, Javier ; Blanquer, José ; Navarro, David ; Camarena, Juan José ; Zaragoza, Rafael ; Abril, Vicente ; Gimeno, Concepci ón ; Hernáez, Silvia ; Ezpeleta, Guillermo ; Bereciartua, Elena ; Hernández Almaraz, José L. ; Montejo, Miguel ; Rivas, Rosa Ana ; Ayarza, Rafael ; Planes, Ana Ma ; Camps, Isabel Ruiz ; Mensa, José ; Gurgui, Mercè ; Sánchez-Reus, Ferran ; Martinez-Montauti, Joaquin ; Sierra, Montserrat ; Horcajada, Juan Pablo ; Sorli, Luisa ; Gómez, Julià ; Gené, Amadeu ; Urrea, Mireia ; Valerio, Maricela ; Puchades, Francesc ; Mularoni, Alessandra. / Candida tropicalis bloodstream infection : Incidence, risk factors and outcome in a population-based surveillance. In: Journal of Infection. 2015 ; Vol. 71, No. 3. pp. 385-394.
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abstract = "Objective: To assess the current clinical features and determinants of outcome of Candida tropicalis bloodstream infection (BSI). Methods: A population-based surveillance on Candida BSI was conducted from May 2010 to April 2011 in 29 Spanish hospitals. Antifungal susceptibility testing (EUCAST methodology) was centrally performed. The characteristics and outcome of C. tropicalis BSI episodes were compared with those due to other species. Results: Fifty-nine out of 752 episodes (7.8{\%}) were due to C. tropicalis (annual incidence: 0.62 cases per 100,000 population). Resistance to fluconazole and voriconazole was found in 23.2{\%} and 26.8{\%} of isolates. Breakthrough BSI occurred in 10.5{\%} of episodes. Risk factors for C. tropicalis BSI were age (odds ratio [OR]: 1.01; P-value = 0.05), underlying leukaemia (OR: 4.77; P-value = 0.001) and chronic lung disease (OR: 2.62; P-value = 0.002). There were no differences in clinical failure (persistent BSI for ≥72 h after initiation of therapy and/or 30-day all-cause mortality) between C. tropicalis (39.6{\%}) and non-C. tropicalis groups (45.6{\%}). The appropriateness of antifungal therapy or the fluconazole MIC values had no significant impact on outcome, whereas early central venous catheter removal exerted a protective effect. Conclusions: C. tropicalis BSI was associated with advanced age, haematological malignancy and respiratory comorbidity. We found no correlation between the unexpectedly high resistance rate to azoles observed and outcome.",
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author = "Mario Fern{\'a}ndez-Ruiz and Mireia Puig-Asensio and Jes{\'u}s Guinea and Benito Almirante and Bel{\'e}n Padilla and Manuel Almela and Ana D{\'i}az-Mart{\'i}n and Jes{\'u}s Rodr{\'i}guez-Ba{\~n}o and Manuel Cuenca-Estrella and Aguado, {Jos{\'e} Mar{\'i}a} and Patricia Mu{\~n}oz and {Pa{\~n}o Pardo}, {Jos{\'e} Ram{\'o}n} and Julio Garc{\'i}a-Rodr{\'i}guez and Cerrada, {Carlos Garc{\'i}a} and Jes{\'u}s Fort{\'u}n and Pilar Mart{\'i}n and Elia G{\'o}mez and Pablo Ryan and Carolina Campelo and Gil, {Ignacio de los Santos} and Ventura Buend{\'i}a and Gorricho, {Beatriz Perez} and Mercedes Alonso and Sanz, {Francisca Sanz} and Paloma Merino and Romo, {Fernando Gonz{\'a}lez} and Miguel Gorgolas and Ignacio Gadea and Losa, {Juan Emilio} and Alberto Delgado-Iribarren and Antonio Ramos and Yolanda Romero and Romero, {Isabel S{\'a}nchez} and Oscar Zaragoza and Jes{\'u}s Rodriguez-Ba{\~n}o and Suarez, {Ana Isabel} and Ana Loza and {Aller Garc{\'i}a}, {Ana Isabel} and Estrella Mart{\'i}n-Mazuelos and {P{\'e}rez de Pipa{\'o}n}, {Maite Ruiz} and Jos{\'e} Garnacho and Carlos Ortiz and M{\'o}nica Ch{\'a}vez and Maroto, {Fernando L.} and Miguel Salavert and Javier Pem{\'a}n and Jos{\'e} Blanquer and David Navarro and Camarena, {Juan Jos{\'e}} and Rafael Zaragoza and Vicente Abril and Gimeno, {Concepci {\'o}n} and Silvia Hern{\'a}ez and Guillermo Ezpeleta and Elena Bereciartua and {Hern{\'a}ndez Almaraz}, {Jos{\'e} L.} and Miguel Montejo and Rivas, {Rosa Ana} and Rafael Ayarza and Planes, {Ana Ma} and Camps, {Isabel Ruiz} and Jos{\'e} Mensa and Merc{\`e} Gurgui and Ferran S{\'a}nchez-Reus and Joaquin Martinez-Montauti and Montserrat Sierra and Horcajada, {Juan Pablo} and Luisa Sorli and Juli{\`a} G{\'o}mez and Amadeu Gen{\'e} and Mireia Urrea and Maricela Valerio and Francesc Puchades and Alessandra Mularoni",
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TY - JOUR

T1 - Candida tropicalis bloodstream infection

T2 - Incidence, risk factors and outcome in a population-based surveillance

AU - Fernández-Ruiz, Mario

AU - Puig-Asensio, Mireia

AU - Guinea, Jesús

AU - Almirante, Benito

AU - Padilla, Belén

AU - Almela, Manuel

AU - Díaz-Martín, Ana

AU - Rodríguez-Baño, Jesús

AU - Cuenca-Estrella, Manuel

AU - Aguado, José María

AU - Muñoz, Patricia

AU - Paño Pardo, José Ramón

AU - García-Rodríguez, Julio

AU - Cerrada, Carlos García

AU - Fortún, Jesús

AU - Martín, Pilar

AU - Gómez, Elia

AU - Ryan, Pablo

AU - Campelo, Carolina

AU - Gil, Ignacio de los Santos

AU - Buendía, Ventura

AU - Gorricho, Beatriz Perez

AU - Alonso, Mercedes

AU - Sanz, Francisca Sanz

AU - Merino, Paloma

AU - Romo, Fernando González

AU - Gorgolas, Miguel

AU - Gadea, Ignacio

AU - Losa, Juan Emilio

AU - Delgado-Iribarren, Alberto

AU - Ramos, Antonio

AU - Romero, Yolanda

AU - Romero, Isabel Sánchez

AU - Zaragoza, Oscar

AU - Rodriguez-Baño, Jesús

AU - Suarez, Ana Isabel

AU - Loza, Ana

AU - Aller García, Ana Isabel

AU - Martín-Mazuelos, Estrella

AU - Pérez de Pipaón, Maite Ruiz

AU - Garnacho, José

AU - Ortiz, Carlos

AU - Chávez, Mónica

AU - Maroto, Fernando L.

AU - Salavert, Miguel

AU - Pemán, Javier

AU - Blanquer, José

AU - Navarro, David

AU - Camarena, Juan José

AU - Zaragoza, Rafael

AU - Abril, Vicente

AU - Gimeno, Concepci ón

AU - Hernáez, Silvia

AU - Ezpeleta, Guillermo

AU - Bereciartua, Elena

AU - Hernández Almaraz, José L.

AU - Montejo, Miguel

AU - Rivas, Rosa Ana

AU - Ayarza, Rafael

AU - Planes, Ana Ma

AU - Camps, Isabel Ruiz

AU - Mensa, José

AU - Gurgui, Mercè

AU - Sánchez-Reus, Ferran

AU - Martinez-Montauti, Joaquin

AU - Sierra, Montserrat

AU - Horcajada, Juan Pablo

AU - Sorli, Luisa

AU - Gómez, Julià

AU - Gené, Amadeu

AU - Urrea, Mireia

AU - Valerio, Maricela

AU - Puchades, Francesc

AU - Mularoni, Alessandra

PY - 2015

Y1 - 2015

N2 - Objective: To assess the current clinical features and determinants of outcome of Candida tropicalis bloodstream infection (BSI). Methods: A population-based surveillance on Candida BSI was conducted from May 2010 to April 2011 in 29 Spanish hospitals. Antifungal susceptibility testing (EUCAST methodology) was centrally performed. The characteristics and outcome of C. tropicalis BSI episodes were compared with those due to other species. Results: Fifty-nine out of 752 episodes (7.8%) were due to C. tropicalis (annual incidence: 0.62 cases per 100,000 population). Resistance to fluconazole and voriconazole was found in 23.2% and 26.8% of isolates. Breakthrough BSI occurred in 10.5% of episodes. Risk factors for C. tropicalis BSI were age (odds ratio [OR]: 1.01; P-value = 0.05), underlying leukaemia (OR: 4.77; P-value = 0.001) and chronic lung disease (OR: 2.62; P-value = 0.002). There were no differences in clinical failure (persistent BSI for ≥72 h after initiation of therapy and/or 30-day all-cause mortality) between C. tropicalis (39.6%) and non-C. tropicalis groups (45.6%). The appropriateness of antifungal therapy or the fluconazole MIC values had no significant impact on outcome, whereas early central venous catheter removal exerted a protective effect. Conclusions: C. tropicalis BSI was associated with advanced age, haematological malignancy and respiratory comorbidity. We found no correlation between the unexpectedly high resistance rate to azoles observed and outcome.

AB - Objective: To assess the current clinical features and determinants of outcome of Candida tropicalis bloodstream infection (BSI). Methods: A population-based surveillance on Candida BSI was conducted from May 2010 to April 2011 in 29 Spanish hospitals. Antifungal susceptibility testing (EUCAST methodology) was centrally performed. The characteristics and outcome of C. tropicalis BSI episodes were compared with those due to other species. Results: Fifty-nine out of 752 episodes (7.8%) were due to C. tropicalis (annual incidence: 0.62 cases per 100,000 population). Resistance to fluconazole and voriconazole was found in 23.2% and 26.8% of isolates. Breakthrough BSI occurred in 10.5% of episodes. Risk factors for C. tropicalis BSI were age (odds ratio [OR]: 1.01; P-value = 0.05), underlying leukaemia (OR: 4.77; P-value = 0.001) and chronic lung disease (OR: 2.62; P-value = 0.002). There were no differences in clinical failure (persistent BSI for ≥72 h after initiation of therapy and/or 30-day all-cause mortality) between C. tropicalis (39.6%) and non-C. tropicalis groups (45.6%). The appropriateness of antifungal therapy or the fluconazole MIC values had no significant impact on outcome, whereas early central venous catheter removal exerted a protective effect. Conclusions: C. tropicalis BSI was associated with advanced age, haematological malignancy and respiratory comorbidity. We found no correlation between the unexpectedly high resistance rate to azoles observed and outcome.

KW - Candida tropicalis bloodstream infection

KW - Epidemiology

KW - Minimum inhibitory concentration

KW - Outcome

KW - Treatment

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DO - 10.1016/j.jinf.2015.05.009

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SP - 385

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JO - Journal of Infection

JF - Journal of Infection

SN - 0163-4453

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