Polymicrobial bloodstream infections involving Candida species: analysis of patients and review of the literature

Stephen A Klotz, Brian S. Chasin, Barbara Powell, Nand K. Gaur, Peter N. Lipke

Research output: Contribution to journalArticle

128 Citations (Scopus)

Abstract

Candida species are the 4th most common cause of nosocomial bloodstream infections in North America. It is not widely appreciated, however, that many of these infections are polymicrobial, that is, that bacteria and occasionally more than 1 species of Candida are present in the same blood culture bottle. Analysis of 2 groups of candidemic patients and a review of the literature were performed. Review of 141 candidemic patients from 8 Veterans Affairs hospitals and 231 patients from a tertiary care hospital with transplant services was performed. Of the 372 patients with candidemia, 100 (27%) had polymicrobial blood cultures: 88 patients (24%) had synchronous bacteremia and 12 patients (3%) had more than 1 species of Candida. One hundred bacteria were isolated from these patients, 69 were Gram positive, and 31 were Gram negative. Candidemia was shown to occur in a setting of polymicrobial bacteremia extending over days, whereas Staphylococcus aureus and coagulase-negative Staphylococcus were less frequently associated with polymicrobial bloodstream infections. Review of more than 8000 reported episodes of candidemia revealed high rates of polymicrobial infection occurring with candidemia. Of blood cultures isolating Candida, 23% were polymicrobial and 4% had more than 1 species of Candida. Thus, almost 1 in 4 patients with candidemia will have a polymicrobial bloodstream infection. As detection of bloodborne infections evolves toward nonculture methodologies, documentation of the frequency of polymicrobial bloodstream infections involving Candida is important. This finding may have treatment implications for clinicians.

Original languageEnglish (US)
Pages (from-to)401-406
Number of pages6
JournalDiagnostic Microbiology and Infectious Disease
Volume59
Issue number4
DOIs
StatePublished - Dec 2007

Fingerprint

Coinfection
Candida
Candidemia
Bacteremia
Bacteria
Veterans Hospitals
Coagulase
Tertiary Healthcare
Cross Infection
North America
Staphylococcus
Tertiary Care Centers
Documentation
Staphylococcus aureus
Transplants
Infection
Blood Culture

Keywords

  • Blood culture
  • Candida
  • Candidemia
  • Polymicrobial blood culture
  • Polymicrobial candidemia

ASJC Scopus subject areas

  • Infectious Diseases
  • Immunology and Allergy
  • Virology
  • Parasitology
  • Microbiology
  • Immunology
  • Applied Microbiology and Biotechnology

Cite this

Polymicrobial bloodstream infections involving Candida species : analysis of patients and review of the literature. / Klotz, Stephen A; Chasin, Brian S.; Powell, Barbara; Gaur, Nand K.; Lipke, Peter N.

In: Diagnostic Microbiology and Infectious Disease, Vol. 59, No. 4, 12.2007, p. 401-406.

Research output: Contribution to journalArticle

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