Candidemia in patients with hematologic malignancies in the era of new antifungal agents (2001‐2007): Stable incidence but changing epidemiology of a still frequently lethal infection

Sipsas, Nikolaos V.; Lewis, Russell E.; Tarrand, Jeffrey; Hachem, Ray; Rolston, Kenneth V.; Raad, Issam I.; Kontoyiannis, Dimitrios P.

doi:10.1002/cncr.24507

Cited by 269Antifungal resistance and susceptibilityNeutropenia and Cancer InfectionsFungal Infections and Studies

Candidemia in patients with hematologic malignancies in the era of new antifungal agents (2001‐2007): Stable incidence but changing epidemiology of a still frequently lethal infection

Sipsas, Nikolaos V., Lewis, Russell E., Tarrand, Jeffrey, Hachem, Ray, Rolston, Kenneth V., Raad, Issam I., Kontoyiannis, Dimitrios P.·2009·Cancer

DOI 10.1002/cncr.24507

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Abstract

BACKGROUND: The incidence, epidemiology, Candida species distribution, resistance patterns, and outcome of candidemia in high-risk hematologic malignancy and/or stem cell transplantation patients have not been extensively described since the introduction of new antifungal agents. METHODS: In this retrospective study, the authors reviewed the medical records and microbiologic data of hematologic malignancy patients with candidemia at The University of Texas M. D. Anderson Cancer Center from March 2001 to February 2007. RESULTS: The authors analyzed 173 episodes of candidemia (170 patients), 125 (72%) of which were breakthrough cases after prior antifungal agents, mainly fluconazole (28 [22%]), caspofungin (25 [20%]), and voriconazole (18 [14%]). The incidence of candidemia (per 100,000 inpatient days) remained relatively stable, from 13.9 in 2001 to 19.2 in 2006. However, compared with the findings of previous studies at the authors' institution, the frequency of Candida glabrata and C. krusei infection decreased (to 5% and 17%, respectively) and C. parapsilosis (24%) and C. tropicalis (21%) increased. C. parapsilosis fungemia was associated with prior caspofungin use (P<.001). The overall 30-day crude mortality rate was 38%, and the attributable mortality rate was 19%, similar to previous findings at the authors' institution. The Candida species associated with the highest mortality rate was C. glabrata. CONCLUSIONS: Despite the widespread use of antifungal prophylaxis and the introduction of new antifungal agents, the incidence and associated mortality rates of candidemia remained stable in high-risk hematologic malignancy patients. However, its epidemiological characteristics have shifted, with C. parapsilosis and C. tropicalis becoming more common.

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The rising incidence of C. parapsilosis in some medical centers has been linked to increased echinocandin use.
“Indeed, the rising incidence of C. parapsilosis in some medical centers has been linked to increased echinocandin use [86,87].”
From Treatment of Invasive Candidiasis: A Narrative Review (2018) · cites this paper as [87]
Increasing echinocandin use was accompanied by epidemiological shifts with a proportional or numeric increase in the less susceptible C. parapsilosis at several centres.
“Quite soon after the introduction of the echinocandins it was noted that the increasing use was accompanied by epidemiological shifts with a proportional or numeric increase in the less susceptible C. parapsilosis at several centres (8;17;18).”
From Echinocandin resistance: an emerging clinical problem? (2014) · cites this paper as [17]

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Authors: Sipsas, N. V., Lewis, R. E., Tarrand, J., Hachem, R., Rolston, K. V., Raad, I. I., & Kontoyiannis, D. P.
Affiliations: The University of Texas MD Anderson Cancer Center (US)
Corresponding author: Kontoyiannis, Dimitrios P.
ORCID: Sipsas, Nikolaos V.
Lewis, Russell E.
Tarrand, Jeffrey
Hachem, Ray
Raad, Issam I.
Kontoyiannis, Dimitrios P.
Venue: Cancer
Publisher: Wiley
Published: 2009-10-05
Volume: 115
Issue: 20
Pages: 4745-4752
ISSN: 0008-543X (ISSN-L)
1097-0142
DOI: 10.1002/cncr.24507
OpenAlex: W1653248413
Cited by: 269
References: 31
Citations by year: 2026: 3 · 2025: 7 · 2024: 12 · 2023: 8 · 2022: 11 · 2021: 9 · 2020: 15 · 2019: 18 · 2018: 10 · 2017: 13 · 2016: 13 · 2015: 19 · 2014: 30 · 2013: 22 · 2012: 29
FWCI: 17.48
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Cancer (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Health Sciences › Medicine › Oncology › Neutropenia and Cancer Infections
Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords: candidemia, hematologic malignancies, stem cell transplantation, antifungal agents, caspofungin, fluconazole, voriconazole, Candida parapsilosis, Candida tropicalis, Candida glabrata, Candida krusei, candidemia incidence, candidemia mortality, antifungal prophylaxis, Candida species distribution
MeSH terms: Adult, Aged, Aged, 80 and over, Antifungal Agents, Candidiasis, Female, Humans, Male, Middle Aged, Retrospective Studies, Incidence, Fungemia, Hematologic Neoplasms

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Candidemia in patients with hematologic malignancies in the era of new antifungal agents (2001‐2007): Stable incidence but changing epidemiology of a still frequently lethal infection

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