Fungemia in cancer patients in Brazil: Predominance of non-albicans species

The objective of this study was to characterize the epidemiology of candidemia in cancer patients in the city of Rio de Janeiro, Brazil. An 18-month survey of fungemia in patients with cancer was undertaken in three Hospitals in Rio de Janeiro. Forty-three episodes of candidemia were identified in 43 patients, 43 of which were episodes of candidemia; in ten cases the strains were not available for further identification of species and were excluded from this analysis. the overall distribution of fungi causing fungemia was: Candida albicans (5), Candida tropicalis (16), Candida parapsilosis (6), Candida guilliermondii (4), Candida lusitaniae (1) and Candida stellatoidea (1). Antifungal prophylaxis had been administered before the episode of fungemia in only six patients (18.2%): oral itraconazole in three patients and oral nistatin, low dose intravenous amphotericin B and oral fluconazole in one patient each. There was no difference in the presence of risk factors, clinical characteristics or in the outcome between albicans and non-albicans species, nor between Candida tropicalis and other non-albicans species. There was a clear predominance of non-albicans species, regardless of the underlying disease, antifungal prophylaxis or the presence of neutropenia.Univ Fed Rio de Janeiro, Univ Hosp, Dept Internal Med, BR-21941 Rio de Janeiro, BrazilState Univ Rio de Janeiro, Univ Hosp, NCI, Rio de Janeiro, BrazilUniversidade Federal de São Paulo, Special Mycol Lab, São Paulo, BrazilUniversidade Federal de São Paulo, Special Mycol Lab, São Paulo, BrazilWeb of Scienc

Risk factors for death among cancer patients with fungemia

In order to identify prognostic factors for death among cancer patients with fungemia, an 18-month survey of fungemia in patients with cancer was undertaken in three hospitals in Rio de Janeiro, for the assessment of risk factors for death, the following variables were analyzed: age; gender; underlying cancer; last treatment for the underlying disease; previous surgery; use of antibiotics, antifungal agents, steroids, or total parenteral nutrition; use of a central venous catheter; chemotherapy; radiotherapy; presence and duration of neutropenia; etiologic agent of the fungemia; treatment of the fungemia; clinical manifestations; and performance status (Karnofsky score) on the day of the positive blood culture, in multivariate analysis, the variables associated with an increased risk for death were older age, persistent neutropenia, and low performance status. Identifying risk factors for death may help to define a group of high-risk patients for whom new therapeutic options should be tried.Univ Fed Rio de Janeiro, Univ Hosp, Rio de Janeiro, BrazilState Univ Rio de Janeiro, Rio de Janeiro, BrazilNatl Canc Inst, Rio de Janeiro, BrazilEscola Paulista Med, Special Mycol Lab, BR-04023 São Paulo, BrazilEscola Paulista Med, Special Mycol Lab, BR-04023 São Paulo, BrazilWeb of Scienc

ESICM LIVES 2016: part two : Milan, Italy. 1-5 October 2016.

Meeting abstrac