TY - JOUR
T1 - Epidemiology and outcomes of invasive candidiasis due to non-albicans species of Candida in 2,496 patients
T2 - Data from the Prospective Antifungal Therapy (PATH) registry 2004-2008
AU - Pfaller, Michael A.
AU - Andes, David R.
AU - Diekema, Daniel J.
AU - Horn, David L.
AU - Reboli, Annette C.
AU - Rotstein, Coleman
AU - Franks, Billy
AU - Azie, Nkechi E.
N1 - Funding Information: The authors would like to acknowledge the contribution of all the PATH investigators who provided data for the PATH Alliance registry. Approval for data collection given by the institutional review boards of Children’s Memorial Hospital, City of Hope National Medical Center, Duke University Medical Center, Emory University, Hamilton Health Sciences, Hôpital Maisonneuve-Rosemont, Johns Hopkins Hospital, MD Anderson – Hematologic Malignancies, MD Anderson – Infectious Diseases, Massachusetts General Hospital, Mount Sinai School of Medicine, Oregon Health & Science University, Thomas Jefferson University Hospital, University of Alabama at Birmingham, University of Arkansas for Medical Sciences, University of Iowa Health Care, University of Miami, University of Michigan Health System, University of Minnesota, University of Nebraska Medical Center, University of Pennsylvania, University of Pittsburgh Medical Center, University of Washington, University of Wisconsin Medical School, and Washington Hospital Center. Editorial support (including editing for journal style, collating comments, and routing reviews) was provided by Jonathon Gibbs BSc., a medical writer at Envision Scientific Solutions. Statistical programming support was provided by Alan Fan from Astellas.
PY - 2014/7/3
Y1 - 2014/7/3
N2 - This analysis describes the epidemiology and outcomes of invasive candidiasis caused by non-albicans species of Candida in patients enrolled in the Prospective Antifungal Therapy Alliance (PATH Alliance) registry from 2004 to 2008. A total of 2,496 patients with non-albicans species of Candida isolates were identified. The identified species were C. glabrata (46.4%), C. parapsilosis (24.7%), C. tropicalis (13.9%), C. krusei (5.5%), C. lusitaniae (1.6%), C. dubliniensis (1.5%) and C. guilliermondii (0.4%); 111 infections involved two or more species of Candida (4.4%). Non-albicans species accounted for more than 50% of all cases of invasive candidiasis in 15 of the 24 sites (62.5%) that contributed more than one case to the survey. Among solid organ transplant recipients, patients with non-transplant surgery, and patients with solid tumors, the most prevalent non-albicans species was C. glabrata at 63.7%, 48.0%, and 53.8%, respectively. In 1,883 patients receiving antifungal therapy on day 3, fluconazole (30.5%) and echinocandins (47.5%) were the most frequently administered monotherapies. Among the 15 reported species, 90-day survival was highest for patients infected with either C. parapsilosis (70.7%) or C. lusitaniae (74.5%) and lowest for patients infected with an unknown species (46.7%) or two or more species (53.2%). In conclusion, this study expands the current knowledge of the epidemiology and outcomes of invasive candidiasis caused by non-albicans species of Candida in North America. The variability in species distribution in these centers underscores the importance of local epidemiology in guiding the selection of antifungal therapy.
AB - This analysis describes the epidemiology and outcomes of invasive candidiasis caused by non-albicans species of Candida in patients enrolled in the Prospective Antifungal Therapy Alliance (PATH Alliance) registry from 2004 to 2008. A total of 2,496 patients with non-albicans species of Candida isolates were identified. The identified species were C. glabrata (46.4%), C. parapsilosis (24.7%), C. tropicalis (13.9%), C. krusei (5.5%), C. lusitaniae (1.6%), C. dubliniensis (1.5%) and C. guilliermondii (0.4%); 111 infections involved two or more species of Candida (4.4%). Non-albicans species accounted for more than 50% of all cases of invasive candidiasis in 15 of the 24 sites (62.5%) that contributed more than one case to the survey. Among solid organ transplant recipients, patients with non-transplant surgery, and patients with solid tumors, the most prevalent non-albicans species was C. glabrata at 63.7%, 48.0%, and 53.8%, respectively. In 1,883 patients receiving antifungal therapy on day 3, fluconazole (30.5%) and echinocandins (47.5%) were the most frequently administered monotherapies. Among the 15 reported species, 90-day survival was highest for patients infected with either C. parapsilosis (70.7%) or C. lusitaniae (74.5%) and lowest for patients infected with an unknown species (46.7%) or two or more species (53.2%). In conclusion, this study expands the current knowledge of the epidemiology and outcomes of invasive candidiasis caused by non-albicans species of Candida in North America. The variability in species distribution in these centers underscores the importance of local epidemiology in guiding the selection of antifungal therapy.
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U2 - https://doi.org/10.1371/journal.pone.0101510
DO - https://doi.org/10.1371/journal.pone.0101510
M3 - Article
C2 - 24991967
SN - 1932-6203
VL - 9
JO - PloS one
JF - PloS one
IS - 7
M1 - e101510
ER -