Fungemia Caused by Candida Species and Torulopsis glabrata in the Hospitalized Patient: Frequency, Characteristics, and Evaluation of Factors Influencing Outcome

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Abstract
We reviewed 135 cases of candidemia occurring between 1983and 1986to examine oncologic and nononcologic populations and assess factors for survival. Candida albieans was the most common species (510/0); Candida tropicalis occurred most frequently in leukemia patients (57%), whereas Candida parapsilosis and Torulopsis glabrata were associated with solid tumors and nononcologic diseases. Risk factors identified were: preceding surgery, antibiotics, cannulas, and steroids in solid tumor and non oncologic diseases; and chemotherapy and neutropenia with hematologic malignancies. Even transient cannulaassociated candidemia was not a benign process. Intravenous cannulas werecommon portals of entry (39%) in debilitated patients without cancer (59%) and were associated with high mortality (55%). Overall mortality was 59%, candidemia directly contributing to death in 750/0 of cases. In patients with candidemia, failure to initiate therapy with amphotericin B had a negative influence on outcome, whereas analysis of the entire group identified severity of underlying illness as the dominant cofactor influencing outcome.

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