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Candidemia in allogeneic blood and marrow transplant recipients: evolution of risk factors after the adoption of prophylactic fluconazole.
J Infect Dis. 2000 Jan; 181(1):309-16.JI

Abstract

The prophylactic use of fluconazole is common in blood and marrow transplant (BMT) recipients. To evaluate how fluconazole has influenced the development of azole resistance and candidemia, weekly mouthwashings were done, and fluconazole susceptibility was determined for 1475 colonizing and invasive isolates obtained from patients undergoing BMT. Of 585 patients, 256 (44%) were colonized with Candida species during the course of BMT. Of these, 136 patients (53%) had at least 1 mouthwashing sample that yielded Candida species other than C. albicans on culture. Only 4.6% of patients developed candidemia. Overall, C. albicans was the most common colonizing isolate, but it caused only 7% of cases of candidemia. About 5% of colonizing C. albicans strains and 100% (2 of 2) invasive C. albicans strains were fluconazole-resistant. Colonization, cytomegalovirus disease, and bacteremia are risk factors for the development of candidemia. The use of prophylactic fluconazole is associated with a low incidence of candidemia and attributable mortality, despite colonization with azole-resistant Candida species in BMT recipients.

Authors+Show Affiliations

Fred Hutchinson Cancer Research Center Program in Infectious Diseases, University of Washington Department of Medicine, Seattle, Washington, USA. kmarr@fhcrc.orgNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

10608780

Citation

Marr, K A., et al. "Candidemia in Allogeneic Blood and Marrow Transplant Recipients: Evolution of Risk Factors After the Adoption of Prophylactic Fluconazole." The Journal of Infectious Diseases, vol. 181, no. 1, 2000, pp. 309-16.
Marr KA, Seidel K, White TC, et al. Candidemia in allogeneic blood and marrow transplant recipients: evolution of risk factors after the adoption of prophylactic fluconazole. J Infect Dis. 2000;181(1):309-16.
Marr, K. A., Seidel, K., White, T. C., & Bowden, R. A. (2000). Candidemia in allogeneic blood and marrow transplant recipients: evolution of risk factors after the adoption of prophylactic fluconazole. The Journal of Infectious Diseases, 181(1), 309-16.
Marr KA, et al. Candidemia in Allogeneic Blood and Marrow Transplant Recipients: Evolution of Risk Factors After the Adoption of Prophylactic Fluconazole. J Infect Dis. 2000;181(1):309-16. PubMed PMID: 10608780.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Candidemia in allogeneic blood and marrow transplant recipients: evolution of risk factors after the adoption of prophylactic fluconazole. AU - Marr,K A, AU - Seidel,K, AU - White,T C, AU - Bowden,R A, PY - 1999/12/23/pubmed PY - 2000/3/21/medline PY - 1999/12/23/entrez SP - 309 EP - 16 JF - The Journal of infectious diseases JO - J. Infect. Dis. VL - 181 IS - 1 N2 - The prophylactic use of fluconazole is common in blood and marrow transplant (BMT) recipients. To evaluate how fluconazole has influenced the development of azole resistance and candidemia, weekly mouthwashings were done, and fluconazole susceptibility was determined for 1475 colonizing and invasive isolates obtained from patients undergoing BMT. Of 585 patients, 256 (44%) were colonized with Candida species during the course of BMT. Of these, 136 patients (53%) had at least 1 mouthwashing sample that yielded Candida species other than C. albicans on culture. Only 4.6% of patients developed candidemia. Overall, C. albicans was the most common colonizing isolate, but it caused only 7% of cases of candidemia. About 5% of colonizing C. albicans strains and 100% (2 of 2) invasive C. albicans strains were fluconazole-resistant. Colonization, cytomegalovirus disease, and bacteremia are risk factors for the development of candidemia. The use of prophylactic fluconazole is associated with a low incidence of candidemia and attributable mortality, despite colonization with azole-resistant Candida species in BMT recipients. SN - 0022-1899 UR - https://www.unboundmedicine.com/medline/citation/10608780/Candidemia_in_allogeneic_blood_and_marrow_transplant_recipients:_evolution_of_risk_factors_after_the_adoption_of_prophylactic_fluconazole_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1086/315193 DB - PRIME DP - Unbound Medicine ER -