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Published on: December 28, 2017
Serotype prevalence of Candida albicans from blood culture isolates
D L Brawner1, G L Anderson, K Y Yuen
1Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, Seattle, Washington 98104-2092.
Insights
Severely immunocompromised patients have a higher risk of fungemia caused by Candida albicans type B. This fungal infection risk is significantly increased in severely immunosuppressed individuals compared to those with underlying risk factors.
Area of Science:
- Mycology
- Infectious Diseases
- Clinical Microbiology
Background:
- Candidemia, a bloodstream infection caused by Candida albicans, poses a significant threat, particularly in hospitalized patients.
- Patient immune status is a critical factor influencing susceptibility to fungal infections.
- Geographic variations in Candida albicans serotype prevalence may impact disease outcomes.
Purpose of the Study:
- To investigate the association between Candida albicans serotype and patient immune status in candidemia.
- To compare the prevalence of Candida albicans serotypes between severely immunosuppressed patients and those with underlying risk factors.
- To explore potential regional differences in serotype distribution and their correlation with candidemia risk.
Main Methods:
- Collection of blood culture isolates of Candida albicans from 102 patients across Seattle and Hong Kong.
- Classification of patients into two groups based on immune status: severe immunosuppression (Group I) and underlying risk factors without immunosuppression (Group II).
- Serotyping of Candida albicans isolates using the Hasenclever tube agglutination method and statistical analysis including logistic regression.
Main Results:
- In Seattle, severely immunosuppressed patients (Group I) had 3.62 times higher odds of fungemia with Candida albicans type B compared to Group II patients.
- While not statistically significant due to small sample sizes in Group II, the trend observed in Hong Kong was consistent with Seattle data.
- Pooled analysis, accounting for immune status across regions, indicated a 5.4-fold increased odds of fungemia with serotype B in Group I patients compared to Group II patients.
Conclusions:
- Severely immunosuppressed patients are significantly more likely to develop candidemia caused by Candida albicans type B.
- Immune status is a stronger determinant of Candida albicans serotype B infection than geographic location.
- These findings highlight the importance of considering both immune status and fungal serotype in managing candidemia.
Abstract:
Blood culture isolates of Candida albicans were collected from 102 patients in Seattle, Wash., hospitals (n = 77) and Hong Kong (n = 25). The patients were classified by immune status into two groups. Group I patients were severely immunosppression, and group II patients had underlying risk factors for candidemia but no underlying immunosuppression. Serotyping by Hasenclever tube agglutination was done. In the Seattle area, the odds of fungemia with type B C. albicans were 3.62 times greater than the odds of type B fungemia in group II patients. Although the odds ratio could not be computed for Hong Kong patients, the direction of the relationship in this population was consistent with the data on Seattle patients. Despite the magnitude of the odds ratios, the relative prevalence of type B over type A in group I compared with group II was not significant when analyzed separately by region, probably because of relatively low numbers of isolates in group II. Accepting that the effect of immune status on serotype is equivalent across regions but presupposing that a regional effect on type B prevalence exists, the pooled odds for fungemia with serotype B in group I patients are increased 5.4-fold over those of group II patients. Logistic regression analysis controlling for region gave similar results.
