A Prospective Observational Study of Risk Factors for Candida glabrata in an SICU: Role of Fluconazole

Background:Candida glabrata has emerged as a serious nosocomial pathogen, particularly in surgical intensive care units (SICU).Purpose: To determine potential risk factors for the emergence of C. glabrata colonization or infection (C/I) in the SICU.Methods: A prospective observational study was conducted collecting and analyzing variables associated with the development of C/I with C. glabrata versus non-glabrata Candida species in our SICU.Results: Fourteen patients developed C/I with C. glabrata (cases), while 21 patients developed C/I with nonglabrata Candida species (controls). Univariate analyses identified the following continuous variables as being statistically significant for the development of C/I with C. glabrata: number of days prior to antifungal or penicillin class therapy. The following categorical variables were significant by univariate analyses: any prior use of piperacillin/tazobactam, penicillin class, or fluconazole, or at least 5 days of use of fluconazole. Any prior use of levofloxa...