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We reviewed 135 cases of candidemia occurring between 1983 and 1986 to examine oncologic and nononcologic populations and assess factors for survival. Candida albicans was the most common species (51%); Candida tropicalis occurred most frequently in leukemia patients (57%), whereas Candida parapsilosis and Torulopsis glabrata were associated with solid tumors and nononcologic diseases. Risk factors identified were: preceding surgery, antibiotics, cannulas, and steroids in solid tumor and nononcologic diseases; and chemotherapy and neutropenia with hematologic malignancies. Even transient cannula-associated candidemia was not a benign process. Intravenous cannulas were common portals of entry (39%) in debilitated patients without cancer (59%) and were associated with high mortality (55%). Overall mortality was 59%, candidemia directly contributing to death in 75% of cases. In patients with candidemia, failure to initiate therapy with amphotericin B had a negative influence on outcome, whereas analysis of the entire group identified severity of underlying illness as the dominant cofactor influencing outcome.
Komshian et al. (Mon,) studied this question.