RT Journal Article
T1 Risk Factors for Fluconazole-Resistant Candidemia
A1 Garnacho-Montero, José
A1 Diaz-Martin, Ana
A1 García-Cabrera, Emilio
A1 Perez de Pipaon, Maite Ruiz
A1 Hernandez-Caballero, Clara
A1 Aznar-Martin, Javier
A1 Cisneros, José Miguel
A1 Ortiz-Leyba, Carlos
K1 Blood-stream infections
K1 Intensive-care-unit
K1 Non-albicans candidemia
K1 Antifungal prophylaxis
K1 Krusei fungemia
K1 Glabrata
K1 Susceptibility
K1 Metaanalysis
K1 Surveillance
K1 Mortality
K1 Science & Technology
K1 Life Sciences & Biomedicine
AB Previous studies have sought to determine the risk factors associated with candidemia caused by non-albicans Candida spp. or with potentially fluconazole-resistant Candida spp. (C. glabrata and C. krusei). Non-albicans Candida strains are a heterogeneous group that includes species with different levels of virulence, and only a limited number of C. glabrata isolates are resistant to fluconazole. We set out to identify the risk factors associated with microbiologically proven fluconazole-resistant candidemia. A prospective study including adult patients with candidemia was performed. Data were collected on patient demographics; underlying diseases; exposure to corticosteroids, antibiotics, or fluconazole; and invasive procedures. Risk factors associated either with non-albicans Candida spp. or potentially fluconazole-resistant Candida spp. (C. glabrata or C. krusei) or with Candida spp. with microbiologically confirmed fluconazole resistance were assessed using logistic regressions. We included 226 candidemia episodes. Non-albicans Candida isolates accounted for 53.1% of the fungal isolates, but only 18.2% of the cases were caused by potentially fluconazole-resistant organisms. Thirty isolates exhibited microbiologically confirmed fluconazole resistance. The multivariate analysis revealed that independent predictors associated with fluconazole-resistant Candida spp. were neutropenia (odds ratio [OR] = 4.94; 95% confidence interval [CI] = 1.50 to 16.20; P = 0.008), chronic renal disease (OR = 4.82; 95% CI = 1.47 to 15.88; P = 0.01), and previous fluconazole exposure (OR = 5.09; 95% CI = 1.66 to 15.6; P = 0.004). Independently significant variables associated with non-albicans Candida bloodstream infection or with potentially fluconazole-resistant Candida spp. did not include previous fluconazole exposure. We concluded that prior fluconazole treatment is an independent risk factor only for candidemia caused by microbiologically confirmed fluconazole resistant species. Our findings may be of value for selecting empirical antifungal therapy.
PB American Society for Microbiology
SN 0066-4804
YR 2010
FD 2010-08
LK https://hdl.handle.net/10668/28453
UL https://hdl.handle.net/10668/28453
LA en
NO Garnacho-Montero J, Díaz-Martín A, García-Cabrera E, Ruiz Pérez de Pipaón M, Hernández-Caballero C, Aznar-Martín J, et al. Risk factors for fluconazole-resistant candidemia. Antimicrob Agents Chemother. 2010 Aug;54(8):3149-54.
NO This study was supported by the Ministerio de Ciencia e Innovación, Instituto de Salud Carlos III, cofinanced by the European Development Regional Fund (A way to achieve Europe) and the Spanish Network for the Research in Infectious Diseases (grant REIPI RD06/ 0008).
DS RISalud
RD Apr 8, 2025