Document Detail


Therapy and outcome of Candida glabrata versus Candida albicans bloodstream infection.
MedLine Citation:
PMID:  18024053     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Candida glabrata is a common cause of bloodstream infection (BSI) and exhibits reduced susceptibility to antifungal agents. Those with C. glabrata BSI may therefore be at increased risk for a delay in receiving appropriate therapy and poor treatment outcome. We compared treatment and outcome of patients with C. glabrata to controls with Candida albicans BSI. Each patient with C. glabrata BSI from July 1997 through December 2004 was matched with a control patient infected with C. albicans. Appropriateness of therapy was defined using current guidelines, and the mortality end point was 30 days following the initial positive blood culture. Overall, 78% of patients received appropriate therapy (39/54 [72%] for C. glabrata versus 45/54 [83%] for C. albicans, P = 0.2). Crude 30-day mortality was high for both groups (41% for C. glabrata versus 44% for C. albicans, P = 0.7). There was no trend in mortality according to time of therapy initiation, but mortality was lower for those who received appropriate therapy (35% versus 71% for inappropriate therapy, P = 0.002). Twelve percent of patients received no antifungal therapy and contributed disproportionately to overall crude mortality. Strategies to decrease the incidence of untreated candidemia may favorably impact outcome.
Authors:
Michael J Klevay; Erika J Ernst; Jesse L Hollanbaugh; Joshua G Miller; Michael A Pfaller; Daniel J Diekema
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-11-19
Journal Detail:
Title:  Diagnostic microbiology and infectious disease     Volume:  60     ISSN:  0732-8893     ISO Abbreviation:  Diagn. Microbiol. Infect. Dis.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-22     Completed Date:  2008-04-11     Revised Date:  2008-09-04    
Medline Journal Info:
Nlm Unique ID:  8305899     Medline TA:  Diagn Microbiol Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  273-7     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Iowa, Iowa City, IA 52242, USA.
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MeSH Terms
Descriptor/Qualifier:
Antifungal Agents / therapeutic use*
Candida albicans / drug effects,  isolation & purification*
Candida glabrata / drug effects,  isolation & purification*
Candidiasis / drug therapy*,  microbiology*,  mortality
Case-Control Studies
Fungemia / drug therapy*,  microbiology*
Humans
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antifungal Agents
Comments/Corrections
Comment In:
Diagn Microbiol Infect Dis. 2008 Jul;61(3):362-3; author reply 364   [PMID:  18342474 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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