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Time to positivity of blood culture can predict different Candida species instead of pathogen concentration in candidemia

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Abstract

The aim of this study was to systematically evaluate the predictive value of time to positivity (TTP) in candidemia. All first episodes of candidemic patients admitted to our hospital between January 2008 and July 2012 were recorded retrospectively. We analyzed the relationship between TTP, identification of Candida species, antifungal agent susceptibility, and patients’ clinical characteristics (30-day mortality, underlying diseases, and associated risk factors). TTP of simulated blood culture with equal inoculum amounts of different Candida species was determined. We included 87 patients during the study period, with a mean TTP of 43.47 ± 19.51 h. TTP of C. glabrata was significantly longer (p < 0.001) and TTP of C. tropicalis was significantly shorter (p < 0.001) than that of other Candida species. Receiver operating characteristic (ROC) curve analysis showed that TTP can predict C. glabrata (with the cut-off value of >45.17 h) and C. tropicalis (with the cut-off value of ≤33.17 h) in candidemia with good sensitivity and specificity. No statistically significant relationship was found between TTP, antifungal agent susceptibility, and patients’ clinical characteristics (p > 0.05). TTP was not a risk factor associated with mortality (p > 0.05). The TTP result in simulated blood culture was in accordance with that of the included patients. TTP has been demonstrated to be helpful to differentiate C. glabrata and C. tropicalis from other Candida species in candidemia, and it is not associated with antifungal agent susceptibility and patients’ clinical characteristics. TTP cannot predict pathogen concentration in the blood of candidemic patients.

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Acknowledgment

The authors would like to thank the clinical microbiology staff of our hospital for the initial processing of the included isolates.

Author contributions

Conceived and designed the experiments: L.H. Performed the experiments and collected the data: L.H., Y.Y.Z., and L.Y.S. Analyzed the data: L.H. Y.Y.Z., and L.Y.S. Wrote the manuscript: L.H.

Funding

This study was partially supported by the National Natural Science Foundation of China to Lei Huang (grant no. 81201338).

Conflict of interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Clinical Laboratory, Peking University First Hospital, Beijing, China

    L. Huang & L. Y. Sun

  2. Department of Clinical Laboratory, Yijishan Hospital, Wannan Medical College, Anhui, China

    Y. Y. Zhang

Authors
  1. L. Huang
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  2. Y. Y. Zhang
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  3. L. Y. Sun
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Corresponding author

Correspondence to L. Huang.

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Huang, L., Zhang, Y.Y. & Sun, L.Y. Time to positivity of blood culture can predict different Candida species instead of pathogen concentration in candidemia. Eur J Clin Microbiol Infect Dis 32, 917–922 (2013). https://doi.org/10.1007/s10096-013-1826-8

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  • DOI: https://doi.org/10.1007/s10096-013-1826-8

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