Quantitation of Candida CFU in initial positive blood cultures

Christopher Pfeiffer, Gregory P. Samsa, Wiley A. Schell, L. Barth Reller, John R. Perfect, Barbara D. Alexander

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

One potential limitation of DNA-based molecular diagnostic tests for Candida bloodstream infection (BSI) is organism burden, which is not sufficiently characterized. We hypothesized that the number of CFU per milliliter (CFU/ml) present in an episode of Candida BSI is too low for reliable DNA-based diagnostics. In this study, we determined Candida burden in the first positive blood culture and explored factors that affect organism numbers and patient outcomes. We reviewed records of consecutive patients with a positive blood culture for Candida in the lysis-centrifugation blood culture system (Isolator, Wampole Laboratories, Cranbury, NJ) from 1987 to 1991. Descriptive statistics and logistic regression analyses were performed. One hundred fifty-two episodes of Candida BSI were analyzed. Patient characteristics included adult age (72%), indwelling central venous catheters (83%), recent surgery (29%), neutropenia (24%), transplant (14%), and other immune suppression (21%). Rates of treatment success and 30-day mortality for candidemia were each 51%. The median CFU/ml was 1 (mode 0.1, range 0.1 to >1,000). In the multivariate analysis, pediatric patients were more likely than adults to have high organism burdens (odds ratio [OR], 10.7; 95% confidence interval [95% CI], 4.3 to 26.5). Initial organism density did not affect patient outcome. Candida CFU/ml in the first positive blood culture of a BSI episode varies greatly; >50% of cultures had ≤1 CFU/ml, a concentration below the experimental yeast cell threshold for reliable DNA-based diagnostics. DNA-based diagnostics for Candida BSI will be challenged by low organism density and the need for sufficient specimen volume; future research on alternate targets is warranted.

Original languageEnglish (US)
Pages (from-to)2879-2883
Number of pages5
JournalJournal of Clinical Microbiology
Volume49
Issue number8
DOIs
StatePublished - Aug 1 2011
Externally publishedYes

Fingerprint

Candida
Infection
DNA
Candidemia
Indwelling Catheters
Molecular Pathology
Central Venous Catheters
Blood Culture
Neutropenia
Centrifugation
Routine Diagnostic Tests
Multivariate Analysis
Yeasts
Logistic Models
Odds Ratio
Regression Analysis
Confidence Intervals
Pediatrics
Transplants
Mortality

ASJC Scopus subject areas

  • Microbiology (medical)

Cite this

Pfeiffer, C., Samsa, G. P., Schell, W. A., Reller, L. B., Perfect, J. R., & Alexander, B. D. (2011). Quantitation of Candida CFU in initial positive blood cultures. Journal of Clinical Microbiology, 49(8), 2879-2883. https://doi.org/10.1128/JCM.00609-11

Quantitation of Candida CFU in initial positive blood cultures. / Pfeiffer, Christopher; Samsa, Gregory P.; Schell, Wiley A.; Reller, L. Barth; Perfect, John R.; Alexander, Barbara D.

In: Journal of Clinical Microbiology, Vol. 49, No. 8, 01.08.2011, p. 2879-2883.

Research output: Contribution to journalArticle

Pfeiffer, C, Samsa, GP, Schell, WA, Reller, LB, Perfect, JR & Alexander, BD 2011, 'Quantitation of Candida CFU in initial positive blood cultures', Journal of Clinical Microbiology, vol. 49, no. 8, pp. 2879-2883. https://doi.org/10.1128/JCM.00609-11
Pfeiffer, Christopher ; Samsa, Gregory P. ; Schell, Wiley A. ; Reller, L. Barth ; Perfect, John R. ; Alexander, Barbara D. / Quantitation of Candida CFU in initial positive blood cultures. In: Journal of Clinical Microbiology. 2011 ; Vol. 49, No. 8. pp. 2879-2883.
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