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@ARTICLE{Wolf:300232,
author = {S. Wolf$^*$ and S. Weber$^*$ and A. Janetta and F. Klein
and J. Enssle$^*$ and M. Hogardt and V. A. J. Kempf and J.
Kessel and M. J. G. T. Vehreschild and B. Steffen and T.
Oellerich$^*$ and H. Serve$^*$ and S. Scheich$^*$},
title = {{E}pidemiology and outcomes of {C}andida spp. bloodstream
infections in cancer patients: a comparative retrospective
study from a {G}erman tertiary cancer center.},
journal = {Infection},
volume = {nn},
issn = {0300-8126},
address = {München},
publisher = {Urban $\&$ Vogel},
reportid = {DKFZ-2025-00694},
pages = {nn},
year = {2025},
note = {epub},
abstract = {Bloodstream infections (BSI) due to Candida spp.
significantly contribute to morbidity and mortality among
cancer patients. Understanding their clinical course, risk
factors, and outcomes compared to bacterial BSI is
essential.We aim to elucidate the epidemiology and risk
factors associated with Candida BSI compared to bacterial
BSI in cancer patients.We analyzed epidemiological data of
Candida BSI versus bacterial BSI among cancer patients,
primarily with hematological malignancies. Blood cultures
were obtained upon clinical suspicion, with species
identification by VITEK 2 and MALDI-TOF. Susceptibility
testing utilized VITEK 2 or antibiotic gradient
tests.Candida BSI was associated with higher 30-day
mortality compared to bacterial BSI (Hazard ratio (HR) 4.5,
$95\%$ CI 2.5-8.1, p < 0.001) occurring predominantly in
patients with relapsed/refractory disease. Univariate
analysis identified risk factors for Candida BSI:
hypoalbuminemia (Odds ratio (OR) 9.13, $95\%$ CI 2.7-57, p =
0.003), prior ICU/MC stay (OR 3.91, $95\%$ CI 1.38-9.65, p =
0.005), palliative treatment (OR 3.42, $95\%$ CI 1.52-7.4, p
= 0.002), parenteral nutrition (OR 2.44, $95\%$ CI 0.9-5.5,
p = 0.039) and prior allogeneic HSCT (OR 2.28, $95\%$ CI
0.92-5.13, p = 0.056). Risk factors identified by
multivariate analysis were palliative therapy (OR 5.23,
$95\%$ CI 3.14-8.71, p = 0.001), hypoalbuminemia (OR 9.02,
$95\%$ CI 4.23-19.2, p = 0.004), and prior ICU/IMC stay (OR
4, $95\%$ CI 2.31-6.92, p = 0.011). In patients with
confirmed Candida BSI, delayed initiation of antifungal was
associated with worse outcomes.Compared to bacterial BSI
events, Candida BSI are associated with significantly higher
30-day mortality, primarily affecting heavily pretreated
patients with relapsed or refractory disease.},
keywords = {Candida (Other) / Acute leukemia (Other) / Bloodstream
infection (Other) / Hematology (Other) / Neutropenic fever
(Other) / Oncology (Other)},
cin = {FM01},
ddc = {610},
cid = {I:(DE-He78)FM01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:40175754},
doi = {10.1007/s15010-025-02513-z},
url = {https://inrepo02.dkfz.de/record/300232},
}