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Immune Reconstitution

Prospective evaluation of Candida species colonization in hospitalized cancer patients: impact on short-term survival in recipients of marrow transplantation and patients with hematological malignancies

Bone Marrow Transplantation volume 30, pages 931–935 (2002)Cite this article

Abstract

Most hematogenous candidiasis originates from endogenous host flora. The impact of clinically prominent Candida colonization on short-term mortality (⩽14 weeks) was prospectively studied in 193 hospitalized patients from 1998 to 1999. Clinically prominent colonization included yeasts isolated from all sterile body sites and >50 colonies of Candida from non-sterile sites. Fourteen (7.1%) patients were granulocytopenic (ANC ⩽100/μl). Nineteen (9.8%) had undergone marrow transplantation, 26 (13.5%) had a hematologic malignancy and 129 (66.5) had non-hematologic cancer. Candida isolates (216) were collected form 210 specimens. Fifty-three (27.5%) patients died; 25 (19.4%) with solid tumors, compared to 16 (61.5%) with hematological malignancy, and 11 (57.9%) BMT recipients (P < 0.001). No deaths were seen in patients with AIDS, and one (7.7%) in a patient with a benign condition (P < 0.001). Twenty-six (29.2%) patients with respiratory tract, 13 (23.2%) with gastrointestinal tract, and three (14.3%) with genitourinary tract colonization died. In patients with multiple-site colonization, mortality was significantly higher (45.5%) (P < 0.05). Mortality was higher in patients with C. glabrata (52.9%) and C. krusei (75%) colonization than with C. albicans (24.1%) (P < 0.025). This study shows that patients with hematologic cancer and recipients of marrow transplant with Candida colonization of multiple body sites, and colonization with C. glabata or C. krusei have poor survival.

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Acknowledgements

Portions of this were presented in part at the 11th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), Istanbul, Turkey, April 2001, and 12th International Symposium on Infections in the Immunocompromised Host of The International Immunocompromised Host Society (ICHS), Bergen, Norway, June 2002. We thank our colleagues at The Microbiology Laboratory, Memorial Sloan-Kettering Cancer Center and Mycology Laboratory, Axelrod Institute, New York State Department of Health, Albany, New York for their support in analysis of Candida isolates.

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  1. A Safdar

    Present address: Department of Infectious Diseases, Infection Control, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, 77030, Texas, USA

Authors and Affiliations

  1. Department of Medicine, and Department of Medicine, Infectious Diseases Service, Memorial Sloan-Kettering Cancer Center (MSKCC), Weill Medical College of Cornell University, New York, NY, USA

    A Safdar & D Armstrong

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Safdar, A., Armstrong, D. Prospective evaluation of Candida species colonization in hospitalized cancer patients: impact on short-term survival in recipients of marrow transplantation and patients with hematological malignancies. Bone Marrow Transplant 30, 931–935 (2002). https://doi.org/10.1038/sj.bmt.1703732

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