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A prospective cohort study evaluating the prognostic impact of clinical characteristics and comorbid conditions of hospitalized adult and pediatric cancer patients with candidemia

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Abstract

The purpose of this study was to describe the clinical aspects of the epidemiology of candidemia and compare the prognostic impact of potential risk factors and the microbiology data of adults and children with cancer. A prospective cohort study enrolling 99 adults and 130 children with candidemia at a tertiary oncology care center in Brazil was undertaken. A total of 229 episodes were analyzed. The overall mortality was higher among adults than in children (37.4% vs. 7.7%, respectively). Univariate analysis revealed significant differences in the risk factors associated with death between both groups. Mortality was similar following fungemia with Candida albicans and all C. non-albicans species. However, significant differences in the interspecies distribution and death rates were observed, mainly among C. glabrata, krusei, and tropicalis species. Multivariate analysis showed comorbidities and neutropenia to be independently associated with mortality in adults, while in children, only comorbidities negatively affected the outcome. Comorbidities were the most important independent prognostic factor in both groups. The inclusion of detailed information about pre-existent illnesses might have a real benefit in studies of candidemia outcome.

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Acknowledgments

We thank the staff at the Clinical Microbiology and Mycology Laboratory of the Hospital do Câncer, Unidade I, National Cancer Institute, Rio de Janeiro, Brazil, for their technical assistance.

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Authors and Affiliations

  1. Infectious Diseases Department, Infection Control Unit, National Cancer Institute, Hospital do Câncer, Unidade I, Rio de Janeiro, Brazil

    E. Velasco

  2. Hematology Department, National Cancer Institute, Hospital do Câncer, Unidade I, Rio de Janeiro, Brazil

    R. Bigni

  3. Rua General Glicério 486/1002; Laranjeiras, 22245-120, Rio de Janeiro, RJ, Brasil

    E. Velasco

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Correspondence to E. Velasco.

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Velasco, E., Bigni, R. A prospective cohort study evaluating the prognostic impact of clinical characteristics and comorbid conditions of hospitalized adult and pediatric cancer patients with candidemia. Eur J Clin Microbiol Infect Dis 27, 1071–1078 (2008). https://doi.org/10.1007/s10096-008-0546-y

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