Risk factors for Candida tropicalis fungemia in patients with cancer

The risk factors for and presentation of Candida tropicalis fungemia, in co mparison with those of Candida albicans, have been incompletely characteriz ed. We compared 43 cases of C. tropicalis fungemia with 148 cases of C. alb icans fungemia. In univariate analysis, patients with C. tropicalis fungemi a were more likely to have leukemia (P=.0006), prolonged neutropenia (P=.03 ), and a positive blood culture for more days (P = .02). The 2 groups did n ot differ with regard to baseline Acute Physiology and Chronic Health Evalu ation (APACHE) II score, frequency of catheter-associated fungemia, or resp onse to antifungals. In multivariate analysis, patients with C. tropicalis fungemia were more likely to have leukemia (P=.02), previous neutropenia (P =.002), and a longer stay in the intensive care unit during the infectious episode (P=.01). Also, the response of the breakthrough C. tropicalis funge mia was lower (P=.05). In conclusion, the host determinants associated with susceptibility to C. tropicalis are leukemia and prolonged neutropenia.