Clinical characteristics and risk factors for mortality in adult patients with persistent candidemia

- Candida tropicalis was the most common pathogen in adult with persistent candidemia.
- CVC and severe sepsis were independently associated with persistent candidemia.
- C. tropicalis was a risk factor for mortality in persistent candidemia.

SummaryBackgroundWe investigated the clinical characteristics and risk factors for mortality in adults with persistent candidemia.MethodsAll patients ≥18 years old with candidemia in two Korean tertiary hospitals from 2007 to 2014 were investigated. Persistent candidemia was defined as isolation of the same Candida species ≥5 days after initiation of antifungal therapy. Non-persistent candidemia was defined as candidemia persisting for ≤3 days after initiation of antifungal therapy.ResultsCandida tropicalis (29.2%) was the most common pathogen in persistent candidemia, and Candida albicans (35.9%) was the most common in non-persistent candidemia. Central venous catheter (CVC) (OR, 1.99; 95% CI, 1.05-3.78; P = 0.034), longer hospital stay (OR 1.01; 95% CI, 1.01-1.02; P = 0.025), and severe sepsis (OR 2.25; 95% CI, 1.11-4.56; P = 0.024) were independent risk factors for persistent candidemia. C. tropicalis was independently related to 30-day mortality (OR, 4.12; 95% CI, 1.27-13.36; P = 0.018), together with septic shock (OR, 5.81; 95% CI, 1.32-24.70; P = 0.017) and use of a corticosteroids (OR, 5.31; 95% CI, 1.07-26.29; P = 0.041) in persistent candidemia.ConclusionC. tropicalis is the predominant pathogen and cause of death in patients with persistent candidemia.