Article Figures & Data
Figures
- FIG. 1.
Scheme showing the actual number of patients experiencing incident episodes of yeast fungemia or recurrences involving single or multiple isolates (mixed infections) and the corresponding number of isolates studied at NRCMA.
- FIG. 2.
Proportion of the five major Candida species responsible for fungemia in patients with (n = 159) or without (n = 2,289) prior exposure to fluconazole (P = 0.001) or with (n = 61) or without (n = 2,387) prior exposure to caspofungin (P < 0.001) (incident episodes and recurrences are included).
Tables
- TABLE 1.
Antifungal susceptibility of the five most frequent Candida species responsible for bloodstream infections according to recent exposure to fluconazole or caspofungin prior to diagnosis of fungemiaa
Exposure drug and antifungal No preexposure recorded Preexposure recorded Pb No. of isolates GMIC (mg/liter) No. of isolates GMIC (mg/liter) Fluconazole Total 2,289 0.77 (0.71-0.83)c 159 2.31 (1.65-3.23) <0.001 C. albicans 1291 0.24 (0.23-0.24) 58 0.36 (0.25-0.51) 0.053 C. glabrata 413 13.97 (12.59-15.50) 46 18.05 (13.19-24.70) 0.129 C. parapsilosis 295 0.97 (0.86-1.08) 23 1.62 (0.99-2.64) 0.015 C. tropicalis 226 0.84 (0.70-1.00) 20 1.52 (0.76-3.01) 0.040 C. krusei 64 34.15 (29.88-39.02) 12 28.51 (10.78-75.41) 0.402 Caspofungin Total 1920 0.07 (0.07-0.08) 61 0.16 (0.12-0.22) <0.001 C. albicans 993 0.05 (0.05-0.05) 13 0.09 (0.04-0.22) 0.252 C. glabrata 365 0.07 (0.07-0.08) 21 0.12 (0.08-0.19) 0.418 C. parapsilosis 299 0.28 (0.26-0.31) 19 0.32 (0.23-0.45) 0.893 C. tropicalis 199 0.06 (0.05-0.06) 0 C. krusei 64 0.15 (0.13-0.17) 8 0.19 (0.11-0.33) 0.571 - TABLE 2.
Characteristics of patients and Candida sp. isolates responsible for incident fungemia according to recorded or not recorded recent exposured to fluconazole or caspofungin
Group and characteristic Recent exposure to fluconazole Recent exposure to caspofungin None recorded (n = 2,305) Recorded (n = 136) P None recorded (n = 2,391) Recorded (n = 50) P Patients Mean age (yr) 56.9 (56.1-57.8)c 50.7 (47.0-54.5) <0.001 56.9 (56.0-57.7) 42.7 (36.7-48.6) <0.001 Male gendera 1,392/2,305 (60.4) 78/136 (57.4) 0.528 1,435/2,391 (60.0) 35/50 (70.0) 0.189 Hematological malignancya 411/2,305 (17.8) 31/136 (22.8) 0.168 414/2,391 (17.3) 28/50 (56.0) <0.001 Intensive care unita 1,073/2,305 (46.6) 80/136 (58.8) 0.006 1,133/2,391 (47.4) 20/50 (40.0) 0.320 Central venous cathetera 1,723/2,305 (74.8) 115/136 (84.6) 0.010 1,793/2,391 (75.0) 45/50 (90.0) 0.012 After diagnosis of fungemia, prescription ofa: Fluconazole 1,233/1,938 (63.6) 43/129 (33.3) <0.001 1,269/2,022 (62.8) 7/45 (15.6) <0.001 Caspofungin 393/1,938 (20.3) 52/129 (40.3) <0.001 424/2,022 (21.0) 21/45 (46.7) <0.001 Death before day 30a 859/2,185 (39.3) 54/134 (40.3) 0.856 892/2,271 (39.3) 21/48 (43.8) 0.552 Early death (<day 8)a 481/846 (56.9) 26/53 (49.1) 0.318 497/878 (56.6) 10/21 (47.6) 0.506 Isolatesb Mixed infectiona 75/2,305 (3.3) 3/136 (2.2) 0.800 77/2,391 (3.2) 1/50 (2.0) 1.000 Non-C. albicans speciesa 1,107/2,377 (46.6) 89/139 (64.0) <0.001 1,157/2,465 (46.9) 39/51 (76.5) <0.001 C. glabrata isolatesa 393/2,377 (16.5) 35/139 (25.2) 0.011 413/2,465 (16.8) 15/51 (29.4) 0.023 Geometric mean MIC (mg/liter) for the isolate causing fungemia Fluconazole 0.77 (0.71-0.83)c 2.14 (1.51-3.04) <0.001 0.80 (0.74-0.86) 2.17 (1.23-3.82) <0.001 Caspofungin 0.07 (0.07-0.08)c 0.08 (0.07-0.09) 0.199 0.07 (0.07-0.07) 0.17 (0.13-0.23) <0.001 Episodes due to at least one isolate with decreased susceptibility toa: Fluconazole 452/2,305 (19.6) 47/136 (34.6) <0.001 480/2,391 (20.1) 19/50 (38.0) 0.004 Caspofungin 121/1,854 (6.5) 10/106 (9.4) 0.231 119/1,910 (6.2) 12/51 (24.0) <0.001 ↵a The data indicate the number of individuals or isolates for whom the corresponding information was available/total number in the group (%).
↵b The total number of isolates studied during incident candidemia was 2,516.
↵c Values in parentheses in this row are 95% CIs.
↵d Recent exposure was <30 days prior to diagnosis of fungemia.
