Vol.73 No.5 September 2025

Exploration of risk factors for the development of fungemia caused by Candida glabrata

Ayaka Nishi¹⁾, Takafumi Sugawara¹⁾, Kazuyuki Tanaka¹⁾, Kae Takemoto¹⁾, Yoshihiro Suyama¹⁾, Nobue Uetake²⁾, Fumitaka Tatsugawa²⁾, Masahiro Kunishige²⁾, Makoto Takenouchi³⁾, Aoi Yamachika⁴⁾, Shinichi Kitamoto²⁾ and Atsushi Watanabe¹⁾

¹⁾Department of Pharmacy, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, Hiroshima, Japan
²⁾Department of Pharmacy, Hiroshima City North Medical Center Asa Citizens Hospital
³⁾Department of Pharmacy, Hiroshima City Funairi Citizens Hospital
⁴⁾Department of Pharmacy, Omi Medical Center

Abstract

Candidemia is an infection that requires urgent attention and early initiation of effective antifungal therapy against the causative fungus. Studies from overseas have reported risk factors, including age over 60 years, history of abdominal surgery, and a history of azole antifungal agent use, for candidemia caused by Candida species, which show a low susceptibility to azole antifungal agents. However, a history of antifungal drug use is likely to be associated with a high risk of candidemia due to breakthrough infection and general studies that include patients with a history of antifungal drug use may overestimate the influence of other factors. Therefore, we evaluated the risk factors for candidemia caused by Candida glabrata in patients with no previous history of antifungal drug use. In addition, to evaluate the relationship between fungi detected in previous culture tests and fungi detected by blood culture as the cause of candidemia, we also determined whether C. glabrata was detected in culture tests other than blood culture during the same hospitalization period. Our results revealed the following as risk factors for the development of candidemia caused by C. glabrata: older age, female sex, and previous history of antimicrobial therapy. Furthermore, C. glabrata was also detected significantly more frequently in previous culture tests in patients with candidemia caused by C. glabrata than in patients with candidemia caused by other Candida species. Thus, if yeast-like fungi are detected in blood culture tests of older patients, females, and patients with a previous history of antimicrobial therapy use, the likely cause of the candidemia is C. glabrata. Furthermore, in patients with suspected candidemia, examining previous culture tests performed during the same hospitalization may help in determining the causative agent of candidemia.

Key word

Candida glabrata, candidemia, fluconazole, risk factor, susceptibility

Received

November 26, 2024

Accepted

April 22, 2025

Jpn. J. Chemother. 73 (5): 361-367, 2025