Candidemia in cancer patients: A prospective, multicenter surveillance study by the Invasive Fungal Infection Group (IFIG) of the European Organization for Research and Treatment of Cancer (EORTC)

In a surveillance study of candidemia in cancer patients that was conducted by the European Organization for Research and Treatment of Cancer, 249 epi sodes were noted; Candida albicans was isolated in 70% (63) of the 90 eases involving patients with solid tumors (tumor patients) and in 36% (58) of t he 159 involving those with hematologic disease (hematology patients). Neut ropenia in tumor patients and acute leukemia and antifungal prophylaxis in hematology patients were significantly associated with non-albicans candide mia in a multivariate analysis. Overall 30-day mortality was 39% (97 of 249 ), In a univariate analysis, Candida glabrata was associated with the highe st mortality rate (odds ratio, 2.66). Two multivariate analyses showed that mortality was associated with older age and severity of the underlying dis ease. Among hematology patients, additional factors associated with mortali ty were allogeneic bone marrow transplantation, septic shock, and lack of a ntifungal prophylaxis.