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Persistent Candidemia: Predictors and Outcomes in a Multicenter Matched Analysis

Summary

This study examined cases where fungal infections caused by Candida persisted in the bloodstream even after starting antifungal treatment. Researchers compared 46 patients with persistent infections to 92 control patients without persistent infections across three major medical centers. Patients with persistent candidemia were younger, more likely to be female, had more health complications, and sadly had much higher death rates (54% vs 31%) within 90 days. The findings suggest that certain patient characteristics and fungal species types may help identify those at higher risk of persistent infections.

Background

Persistent candidemia (PC) occurs in a minority of Candida bloodstream infections but is associated with increased morbidity. Comparative data on patient profile, species distribution and outcomes in PC cases are limited.

Objective

To identify predictors and outcomes of persistent candidemia by comparing patient demographics, Candida species distribution, and clinical outcomes between PC and non-PC cases across three academic medical centers.

Results

PC patients were younger (62 vs 68 years), more often female (59% vs 30%), and had higher comorbidity burden (CCI 5 vs 3). C. guilliermondii was over-represented in PC cases (9% vs 0%). PC cases had longer hospital stays (36 vs 16 days) and significantly higher 90-day mortality (54.3% vs 31.5%, OR 2.57).

Conclusion

This 7-year multicenter study identified significant differences in demographics, microbiology, and clinical outcomes between PC and non-PC cases, including higher short-term mortality rates with persistent candidemia in univariate analysis.
  • Published in:Open Forum Infectious Diseases,
  • Study Type:Multicenter Matched Cohort Study,
  • Source: 10.1093/ofid/ofaf695.2103, PMC12793474
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