Rare opportunistic (non-Candida, non-Cryptococcus) yeast bloodstream infections in patients with cancer.
Background: Rare opportunistic (non-Candida, non-Cryptococcus) yeast bloodstream infections (ROYBSIs) are rare, even in cancer patients.Methods: We retrospectively reviewed all episodes of ROYBSIs occurring from 1998 to 2010 in our cancer center.Results: Of 2984 blood cultures positive for Candida a...
| Published in: | Journal of Infection Vol. 64; no. 1; pp. 68 - 76 |
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| Main Authors: | , , , , , , , , , , , |
| Format: | research Journal Article |
| Published: |
W B Saunders
Jan2012
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104434975&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104434975 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01634453 8IL jtl: Journal of Infection issn: 01634453 maglogo: N pubinfo: dt: Jan2012 vid: 64 iid: 1 pid: 1351 pub: W B Saunders place: Philadelphia, Pennsylvania artinfo: ui: 104434975 NLM22101079 2011732652 10.1016/j.jinf.2011.11.002 NLM22101079 PMC3855381 104434975 ppf: 68 ppct: 8 formats: tig: atl: Rare opportunistic (non-Candida, non-Cryptococcus) yeast bloodstream infections in patients with cancer. aug: au: Chitasombat MN Kofteridis DP Jiang Y Tarrand J Lewis RE Kontoyiannis DP Chitasombat, Maria N Kofteridis, Diamantis P Jiang, Ying Tarrand, Jeffrey Lewis, Russell E Kontoyiannis, Dimitrios P affil: Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA sug: subj: Fungemia Epidemiology Fungemia Microbiology Neoplasms Complications Opportunistic Infections Epidemiology Opportunistic Infections Microbiology Yeasts Classification Yeasts Adolescence Adult Aged Aged, 80 and Over Antifungal Agents Administration and Dosage Antifungal Agents Pharmacodynamics Catheter-Related Infections Epidemiology Catheter-Related Infections Microbiology Catheter-Related Infections Mortality Child Drug Resistance, Microbial Female Fungemia Mortality Human Male Middle Age Opportunistic Infections Mortality Retrospective Design Survival Analysis Yeasts Drug Effects Young Adult Adolescent: 13-18 years Adult: 19-44 years Aged: 65+ years Aged, 80 & over Child: 6-12 years Middle Aged: 45-64 years Female Male ab: Background: Rare opportunistic (non-Candida, non-Cryptococcus) yeast bloodstream infections (ROYBSIs) are rare, even in cancer patients.Methods: We retrospectively reviewed all episodes of ROYBSIs occurring from 1998 to 2010 in our cancer center.Results: Of 2984 blood cultures positive for Candida and non-Candida yeasts, 94 (3.1%) were positive for non-Candida yeasts, representing 41 ROYBSIs (incidence, 2.1 cases/100,000 patient-days). Catheter-associated fungemia occurred in 21 (51%) patients. Breakthrough ROYBSIs occurred in 20 (49%) patients. The yeast species distribution was Rhodotorula in 21 (51%) patients, Trichosporon in 8 (20%) patients, Saccharomyces cerevisiae in 8 (20%) patients, Geotrichum in 2 (5%) patients, Pichia anomala, and Malassezia furfur in 1 patient each. All tested Trichosporon, Geotrichum, and Pichia isolates were azole-susceptible, whereas the Rhodotorula isolates were mostly azole-resistant. We noted echinocandin nonsusceptibility (minimal inhibitory concentration ≥ 2 mg/L) in all but the S. cerevisiae isolates. Most of the isolates (28/33 [85%]) were susceptible to amphotericin B. The mortality rate in all patients at 30 days after ROYBSIs diagnosis was 34%. Multivariate survival analysis revealed increased risk of death in patients with S. cerevisiae infections (hazard ratio, 3.7), Geotrichum infections (hazard ratio, 111.3), or disseminated infections (hazard ratio, 33.4) and reduced risk in patients who had catheter removal (hazard ratio, 0.1).Conclusions: ROYBSIs are uncommon in patients with cancer, and catheters are common sources of them. Half of the ROYBSIs occurred as breakthrough infections, and in vitro species-specific resistance to echinocandins and azoles was common. Disseminated infections resulted in the high mortality rate. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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