Epidemiology and outcomes of invasive candidiasis due to non-albicans species of Candida in 2,496 patients: data from the Prospective Antifungal Therapy (PATH) registry 2004-2008

Michael A Pfaller; David R Andes; Daniel J Diekema; David L Horn; Annette C Reboli; Coleman Rotstein; Billy Franks; Nkechi E Azie

doi:10.1371/journal.pone.0101510

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Epidemiology and outcomes of invasive candidiasis due to non-albicans species of Candida in 2,496 patients: data from the Prospective Antifungal Therapy (PATH) registry 2004-2008

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Epidemiology and outcomes of invasive candidiasis due to non-albicans species of Candida in 2,496 patients: data from the Prospective Antifungal Therapy (PATH) registry 2004-2008

Michael A Pfaller, David R Andes, Daniel J Diekema, David L Horn, Annette C Reboli, Coleman Rotstein, Billy Franks and Nkechi E Azie

PloS one, Vol.9(7), pp.e101510-e101510

2014

DOI: 10.1371/journal.pone.0101510

PMCID: PMC4081561

PMID: 24991967

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Abstract

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.

Fluconazole - pharmacology

Prevalence

Prospective Studies

Humans

Middle Aged

Child, Preschool

Infant

Male

Fluconazole - therapeutic use

Antifungal Agents - therapeutic use

Candidiasis, Invasive - mortality

Young Adult

Candidiasis, Invasive - drug therapy

Aged, 80 and over

Adult

Female

Registries

Drug Therapy, Combination

Child

Echinocandins - pharmacology

Antifungal Agents - pharmacology

Candidiasis, Invasive - epidemiology

Survival Rate

Treatment Outcome

Candida - isolation & purification

Adolescent

Echinocandins - therapeutic use

Aged

Candida - drug effects

Details

Title: Subtitle: Epidemiology and outcomes of invasive candidiasis due to non-albicans species of Candida in 2,496 patients: data from the Prospective Antifungal Therapy (PATH) registry 2004-2008
Creators: Michael A Pfaller - JMI Laboratories, North Liberty, Iowa, United States of America; Department of Pathology, University of Iowa, Iowa City, Iowa, United States of America
David R Andes - Department of Medicine, University of Wisconsin, Madison, Wisconsin, United States of America
Daniel J Diekema - Department of Pathology, University of Iowa, Iowa City, Iowa, United States of America
David L Horn - David Horn LLC, Doylestown, Pennsylvania, United States of America
Annette C Reboli - Department of Medicine, Cooper Medical School of Rowan University, Camden, New Jersey, United States of America
Coleman Rotstein - Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
Billy Franks - Astellas Scientific and Medical Affairs, Northbrook, Illinois, United States of America
Nkechi E Azie - Astellas Scientific and Medical Affairs, Northbrook, Illinois, United States of America
Resource Type: Journal article
Publication Details: PloS one, Vol.9(7), pp.e101510-e101510
DOI: 10.1371/journal.pone.0101510
PMID: 24991967
PMCID: PMC4081561
NLM abbreviation: PLoS One
ISSN: 1932-6203
eISSN: 1932-6203
Publisher: United States
Language: English
Date published: 2014
Academic Unit: Infectious Diseases; Epidemiology; Pathology; Internal Medicine
Record Identifier: 9983986363002771

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