This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Almirante, B. Search for Related Content PubMed PubMed Citation Articles by Almirante, B.

Epidemiology, Risk Factors, and Prognosis of Candida parapsilosis Bloodstream Infections: Case-Control Population-Based Surveillance Study of Patients in Barcelona, Spain, from 2002 to 2003

Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain,¹ Mycology Department, Instituto de Salud Carlos III, Madrid, Spain,² Microbiology Department, Hospital Clinic-IDIBAPS, Barcelona, Spain,³ Microbiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain,⁴ Microbiology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain,⁵ Microbiology Department, Hospital General de L'Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain⁶

Received 7 January 2006/ Returned for modification 22 February 2006/ Accepted 28 February 2006

Candida parapsilosis has emerged as an important yeast species causing fungemia. We describe the incidence and epidemiology of C. parapsilosis fungemia. Data from active population-based surveillance in Barcelona, Spain, from January 2002 to December 2003 were analyzed. We focused on 78 episodes of C. parapsilosis fungemia, and we compared them with 175 Candida albicans controls. C. parapsilosis accounted for 23% of all fungemias. The annual incidences were 1 episode per 10⁵ patients, 1.2 episodes per 10⁴ discharges, and 1.7 episodes per 10⁵ patient days. All isolates but one (99%) were fluconazole susceptible. Seventy-two isolates (92%) were inpatient candidemias. Forty-two episodes (51%) were considered catheter-related fungemia, 35 (45%) were considered primary fungemia, and 3 (4%) were considered secondary fungemia. Risk factors for candidemia were vascular catheterization (97%), prior antibiotic therapy (91%), parenteral nutrition (54%), prior surgery (46%), prior immunosuppressive therapy (38%), malignancy (27%), prior antifungal infection (26%), transplant recipient (16%), neutropenia (12%), and prior colonization (11%). Multivariate analysis of the differential characteristics showed that the factors that independently predicted the presence of C. parapsilosis fungemia were neonate patients (odds ratio [OR], 7.5; 95% confidence interval [CI], 2.1 to 26.8; P = 0.002), transplant recipients (OR, 9.2; 95% CI, 1.9 to 43.3; P = 0.005), patients with a history of prior antifungal therapy (OR, 5.4; 95% CI, 1.8 to 15.9; P = 0.002), and patients who received parenteral nutrition (OR, 2.2; 95% CI, 1.09 to 4.6; P = 0.028). The overall mortality rate was lower than that associated with C. albicans candidemia (23% versus 43%; P < 0.01). In summary, C. parapsilosis was responsible for 23% of all candidemias and was more frequent in neonates, in transplant recipients, and in patients who received parenteral nutrition or previous antifungal therapy, mainly fluconazole. The mortality rate was lower than that associated with C. albicans fungemia.

This article has been cited by other articles:

• Garcia-Effron, G., Katiyar, S. K., Park, S., Edlind, T. D., Perlin, D. S. (2008). A Naturally Occurring Proline-to-Alanine Amino Acid Change in Fks1p in Candida parapsilosis, Candida orthopsilosis, and Candida metapsilosis Accounts for Reduced Echinocandin Susceptibility. Antimicrob. Agents Chemother. 52: 2305-2312 [Abstract] [Full Text]  
• Gomez-Lopez, A., Alastruey-Izquierdo, A., Rodriguez, D., Almirante, B., Pahissa, A., Rodriguez-Tudela, J. L., Cuenca-Estrella, M., and the Barcelona Candidemia Project Study Group, (2008). Prevalence and Susceptibility Profile of Candida metapsilosis and Candida orthopsilosis: Results from Population-Based Surveillance of Candidemia in Spain. Antimicrob. Agents Chemother. 52: 1506-1509 [Abstract] [Full Text]  
• Pfaller, M. A., Diekema, D. J., Gibbs, D. L., Newell, V. A., Ng, K. P., Colombo, A., Finquelievich, J., Barnes, R., Wadula, J., the Global Antifungal Surveillance Group, (2008). Geographic and Temporal Trends in Isolation and Antifungal Susceptibility of Candida parapsilosis: a Global Assessment from the ARTEMIS DISK Antifungal Surveillance Program, 2001 to 2005. J. Clin. Microbiol. 46: 842-849 [Abstract] [Full Text]  
• Ding, C., Butler, G. (2007). Development of a Gene Knockout System in Candida parapsilosis Reveals a Conserved Role for BCR1 in Biofilm Formation. Eukaryot Cell 6: 1310-1319 [Abstract] [Full Text]  
• Tavanti, A., Hensgens, L. A. M., Ghelardi, E., Campa, M., Senesi, S. (2007). Genotyping of Candida orthopsilosis Clinical Isolates by Amplification Fragment Length Polymorphism Reveals Genetic Diversity among Independent Isolates and Strain Maintenance within Patients. J. Clin. Microbiol. 45: 1455-1462 [Abstract] [Full Text]  
• Pisa, D., Ramos, M., Molina, S., Garcia, P., Carrasco, L. (2007). Evolution of antibody response and fungal antigens in the serum of a patient infected with Candida famata. J Med Microbiol 56: 571-578 [Abstract] [Full Text]  
• Drew, R. H (2007). Could Risk Assessment for Non-albicans Candida Improve Empiric Treatment for Invasive Candidiasis?. The Annals of Pharmacotherapy 41: 690-692 [Abstract] [Full Text]  
• Kocsube, S., Toth, M., Vagvolgyi, C., Doczi, I., Pesti, M., Pocsi, I., Szabo, J., Varga, J. (2007). Occurrence and genetic variability of Candida parapsilosis sensu lato in Hungary. J Med Microbiol 56: 190-195 [Abstract] [Full Text]  
• Pfaller, M. A., Diekema, D. J. (2007). Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem. Clin. Microbiol. Rev. 20: 133-163 [Abstract] [Full Text]