Skip to main content

Quantitation of Candida CFU in initial positive blood cultures.

Publication ,  Journal Article
Pfeiffer, CD; Samsa, GP; Schell, WA; Reller, LB; Perfect, JR; Alexander, BD
Published in: J Clin Microbiol
August 2011

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.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Clin Microbiol

DOI

EISSN

1098-660X

Publication Date

August 2011

Volume

49

Issue

8

Start / End Page

2879 / 2883

Location

United States

Related Subject Headings

  • Microbiology
  • Male
  • Infant
  • Humans
  • Female
  • Colony Count, Microbial
  • Child, Preschool
  • Child
  • Candidemia
  • Candida
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Pfeiffer, C. D., 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. J Clin Microbiol, 49(8), 2879–2883. https://doi.org/10.1128/JCM.00609-11
Pfeiffer, Christopher D., Gregory P. Samsa, Wiley A. Schell, L Barth Reller, John R. Perfect, and Barbara D. Alexander. “Quantitation of Candida CFU in initial positive blood cultures.J Clin Microbiol 49, no. 8 (August 2011): 2879–83. https://doi.org/10.1128/JCM.00609-11.
Pfeiffer CD, Samsa GP, Schell WA, Reller LB, Perfect JR, Alexander BD. Quantitation of Candida CFU in initial positive blood cultures. J Clin Microbiol. 2011 Aug;49(8):2879–83.
Pfeiffer, Christopher D., et al. “Quantitation of Candida CFU in initial positive blood cultures.J Clin Microbiol, vol. 49, no. 8, Aug. 2011, pp. 2879–83. Pubmed, doi:10.1128/JCM.00609-11.
Pfeiffer CD, Samsa GP, Schell WA, Reller LB, Perfect JR, Alexander BD. Quantitation of Candida CFU in initial positive blood cultures. J Clin Microbiol. 2011 Aug;49(8):2879–2883.

Published In

J Clin Microbiol

DOI

EISSN

1098-660X

Publication Date

August 2011

Volume

49

Issue

8

Start / End Page

2879 / 2883

Location

United States

Related Subject Headings

  • Microbiology
  • Male
  • Infant
  • Humans
  • Female
  • Colony Count, Microbial
  • Child, Preschool
  • Child
  • Candidemia
  • Candida