Epidemiology of Candida kefyr in Patients with Hematologic Malignancies.

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Epidemiology of Candida kefyr in Patients with Hematologic Malignancies.

J Clin Microbiol. 2014 Mar 12;

Authors: Dufresne SF, Marr KA, Sydnor E, Staab JF, Karp JE, Lu K, Zhang SX, Lavallée C, Perl TM, Neofytos D

Abstract
Candida kefyr (Ck) is an emerging pathogen among patients with hematologic malignancies (HM). We performed a retrospective study at Johns Hopkins Hospital to evaluate the epidemiology of Ck colonization and infection in HM patients between 2004 and 2010. 83 patients were colonized and/or infected with Ck, with 8 (9.6%) having invasive candidiasis (IC). The yearly incidence of Ck colonization and candidemia increased over the study period (p<0.01), particularly after 2009. In 2010, Ck caused 16.7% of candidemia episodes. The monthly incidence of Ck was higher during the summer throughout the study. In a cohort of patients with acute myelogenic leukemia receiving induction chemotherapy, risks for Ck colonization included the summer season (odds ratio [OR] 3.1; p=0.03); administration of an azole (OR 0.06; p<0.001) or amphotericin-B (OR 0.35; p=0.05) were protective. Fingerprinting of 16 isolates by repetitive sequence-based PCR showed that all were different genotypes. The epidemiology of Ck candidemia was evaluated in another hospital in Montreal; data confirmed higher rates of Ck infection in the summer. Ck appears to be increasing in HM patients, with prominent summer seasonality. These findings raise questions about the effect of antifungal agents and healthcare exposures (e.g. yogurt) on the epidemiology of this yeast.

PMID: 24622105 [PubMed - as supplied by publisher]