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This study aimed to investigate the risk factors for and the outcomes of patients with candidemia caused by non- albicans Candida . Candidemia patients treated at Siriraj Hospital (Bangkok, Thailand) during January 2016 to December 2017 were enrolled. A total of 156 patients (mean age: 65 years, 56.4% male) were included. The most prevalent underlying conditions were diabetes (32.1%), chronic cardiac disease (28.2%), chronic kidney disease (26.9%), and hematologic malignancies (21.2%).  Candida  species isolated from patient blood were  C. tropicalis  (49.4%),  C. albicans  (28.8%),  C. glabrata  (16.7%), and  C. parapsilosis  (5.1%). Fluconazole resistance was significantly increased in  C. tropicalis  (37.8%). No independent risk factors were associated with patients with non- albicans Candida  candidemia compared to those with  C. albicans  candidemia. There was no significant difference in mortality between patients with non- albicans Candida  candidemia and patients with  C. albicans  candidemia (OR: 1.35, 95% CI: 0.64–2.85). When compared with  C. albicans  candidemia, multivariate analysis revealed chronic liver disease (OR: 11.39, 95% CI: 1.38–94.02), neutropenia (OR: 4.31, 95% CI: 1.34–13.87), and male gender (OR: 2.34, 95% CI: 1.04–5.29) to be independent risk factors for  C. tropicalis  candidemia. The observed high resistance of  C. tropicalis  to fluconazole indicates that fluconazole should not be used for empirical antifungal treatment in these patients.

journal of fungi

Risk Factors and Outcomes of Non-albicans Candida Bloodstream Infection in Patients with Candidemia at Siriraj Hospital—Thailand’s Largest National Tertiary Referral Hospital