Tags

Type your tag names separated by a space and hit enter

Candida glabrata and Candida krusei fungemia after high-risk allogeneic marrow transplantation: no adverse effect of low-dose fluconazole prophylaxis on incidence and outcome.
Bone Marrow Transplant. 2001 Nov; 28(9):873-8.BM

Abstract

Candidemia is a serious complication in patients following allogeneic blood, marrow, and organ transplantation. Fourteen patients developed nosocomial fungemia among 204 allogeneic marrow transplants performed during 1997-1999. Incidence of hematogenous candidiasis was 6.8 per 100 allogeneic BMT. All 14 had an indwelling central venous catheter (CVC) and fluconazole (100-200 mg daily) was given prophylactically. In 11 (78.5%) neutropenic patients, duration between agranulocytosis and diagnosis of fungemia was (median, +/- s.d.) 10 +/- 8 days. Candida glabrata (53.3%) was the most common yeast species, followed by C. krusei (33.3%), and C. parapsilosis (13.3%). Candida albicans was conspicuously absent. Ten patients (71.4%) had primary transplant-related complication (>2 days) including hemolytic uremic syndrome/thrombotic thrombocytopenic purpura (HUS/TTP) (n = 5), severe hemorrhagic cystitis (n = 3), and bacteremia (n = 2). Seven (50.0%) patients expired and in three (21.4%) deaths were attributed to fungemia. The impact of a primary transplant-related complication on short-term survival in this setting was not significant (P = 0.07) (HUS/TTP (P > 0.5); neutropenia (P > 0.5); GVHD (P = 0.35)). Removal of CVC did not alter outcome in our group (P > or = 0.5) although in patients with persistent fungemia (>72 h), and those with preceding bacteremia, mortality was significantly higher (P = 0.002). Conventional prognosticators of poor outcome did not adversely effect short-term survival in our transplant recipients with hematogenous candidiasis. The predominance of C. glabrata and C. krusei breakthrough infections was similar to what is seen with high-dose fluconazole (400 mg) prophylaxis, and no adverse effects of low-dose fluconazole in terms of increased incidence of non-susceptible Candida species was seen.

Authors+Show Affiliations

Division of Infectious Diseases, Department of Medicine, University of South Carolina School of Medicine, Columbia, SC 29203, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11781648

Citation

Safdar, A, et al. "Candida Glabrata and Candida Krusei Fungemia After High-risk Allogeneic Marrow Transplantation: No Adverse Effect of Low-dose Fluconazole Prophylaxis On Incidence and Outcome." Bone Marrow Transplantation, vol. 28, no. 9, 2001, pp. 873-8.
Safdar A, van Rhee F, Henslee-Downey JP, et al. Candida glabrata and Candida krusei fungemia after high-risk allogeneic marrow transplantation: no adverse effect of low-dose fluconazole prophylaxis on incidence and outcome. Bone Marrow Transplant. 2001;28(9):873-8.
Safdar, A., van Rhee, F., Henslee-Downey, J. P., Singhal, S., & Mehta, J. (2001). Candida glabrata and Candida krusei fungemia after high-risk allogeneic marrow transplantation: no adverse effect of low-dose fluconazole prophylaxis on incidence and outcome. Bone Marrow Transplantation, 28(9), 873-8.
Safdar A, et al. Candida Glabrata and Candida Krusei Fungemia After High-risk Allogeneic Marrow Transplantation: No Adverse Effect of Low-dose Fluconazole Prophylaxis On Incidence and Outcome. Bone Marrow Transplant. 2001;28(9):873-8. PubMed PMID: 11781648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Candida glabrata and Candida krusei fungemia after high-risk allogeneic marrow transplantation: no adverse effect of low-dose fluconazole prophylaxis on incidence and outcome. AU - Safdar,A, AU - van Rhee,F, AU - Henslee-Downey,J P, AU - Singhal,S, AU - Mehta,J, PY - 2001/04/20/received PY - 2001/08/23/accepted PY - 2002/1/10/pubmed PY - 2002/4/18/medline PY - 2002/1/10/entrez SP - 873 EP - 8 JF - Bone marrow transplantation JO - Bone Marrow Transplant. VL - 28 IS - 9 N2 - Candidemia is a serious complication in patients following allogeneic blood, marrow, and organ transplantation. Fourteen patients developed nosocomial fungemia among 204 allogeneic marrow transplants performed during 1997-1999. Incidence of hematogenous candidiasis was 6.8 per 100 allogeneic BMT. All 14 had an indwelling central venous catheter (CVC) and fluconazole (100-200 mg daily) was given prophylactically. In 11 (78.5%) neutropenic patients, duration between agranulocytosis and diagnosis of fungemia was (median, +/- s.d.) 10 +/- 8 days. Candida glabrata (53.3%) was the most common yeast species, followed by C. krusei (33.3%), and C. parapsilosis (13.3%). Candida albicans was conspicuously absent. Ten patients (71.4%) had primary transplant-related complication (>2 days) including hemolytic uremic syndrome/thrombotic thrombocytopenic purpura (HUS/TTP) (n = 5), severe hemorrhagic cystitis (n = 3), and bacteremia (n = 2). Seven (50.0%) patients expired and in three (21.4%) deaths were attributed to fungemia. The impact of a primary transplant-related complication on short-term survival in this setting was not significant (P = 0.07) (HUS/TTP (P > 0.5); neutropenia (P > 0.5); GVHD (P = 0.35)). Removal of CVC did not alter outcome in our group (P > or = 0.5) although in patients with persistent fungemia (>72 h), and those with preceding bacteremia, mortality was significantly higher (P = 0.002). Conventional prognosticators of poor outcome did not adversely effect short-term survival in our transplant recipients with hematogenous candidiasis. The predominance of C. glabrata and C. krusei breakthrough infections was similar to what is seen with high-dose fluconazole (400 mg) prophylaxis, and no adverse effects of low-dose fluconazole in terms of increased incidence of non-susceptible Candida species was seen. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/11781648/Candida_glabrata_and_Candida_krusei_fungemia_after_high_risk_allogeneic_marrow_transplantation:_no_adverse_effect_of_low_dose_fluconazole_prophylaxis_on_incidence_and_outcome_ L2 - http://dx.doi.org/10.1038/sj.bmt.1703252 DB - PRIME DP - Unbound Medicine ER -