Comparison of albicans vs. non-albicans candidemia in French intensive care units.
Crit Care. 2010 May 27;14(3):R98
Authors: Leroy O, Mira JP, Montravers P, Gangneux JP, Lortholary O
ABSTRACT: INTRODUCTION: Candidemia raises numerous therapeutic issues for intensive care physicians. Epidemiological data that could guide the choice of initial therapy are still required. This analysis sought to compare the characteristics of intensive care unit (ICU) patients with candidemia due to non-albicans Candida species with those of ICU patients with candidemia due to Candida albicans. METHODS: Prospective, observational, multicenter, French study (October 2005 to May 2006). Patients exhibiting candidemia developed during ICU stay and exclusively due either to one or more non-albicans C. species or to C. albicans were selected. The data collected included patients characteristics on ICU admission and at the onset of candidemia. RESULTS: Among the 136 patients analyzed, 78 (57.4%) had candidemia caused by C. albicans. These patients had earlier onset of infection (11.1 +/- 14.2 days after ICU admission vs. 17.4 +/- 17.7, P=0.02), higher severity scores on ICU admission (SOFA: 10.4 +/- 4.7 vs. 8.6 +/- 4.6, P=0.03; SAPS II: 57.4 +/- 22.8 vs. 48.7 +/- 15.5, p = 0.015), and were less often neutropenic (2.6% vs. 12%, P=0.04) than patients with candidemia due to non-albicans C. species. CONCLUSIONS: Although patients infected with Candida albicans differed from patients infected with non-albicans Candida species for a few characteristics, no clinical factor appeared pertinent enough to guide the choice of empirical antifungal therapy in ICU.
PMID: 20507569 [PubMed - as supplied by publisher]