Hirano R, et al. - Researchers primarily assessed the prognostic factors of candidemia and secondarily elucidated the microbiological characteristics of patients with breakthrough (BT) candidemia. The 30-day mortality rate was investigated in a total of 121 patients diagnosed with candidemia between January 2007 and December 2016. Multivariate Cox hazard analysis revealed C. albicans, the absence of antifungal therapy, age, lung disease, and mechanical ventilation to be associated with a high mortality rate, whereas C. parapsilosis, the removal of a central venous catheter, and surgical wards to be associated with a lower mortality rate. They recognized 14 patients with BT candidemia. Patients with and without BT candidemia showed a significant difference in the proportion of C. guilliermondii and other Candida species exhibiting resistance to fluconazole and voriconazole. Findings thus suggest prompt initiation of antifungal therapy and removal of central venous ­catheter as necessary for better outcomes. In empirical antifungal therapy for BT candidemia with a history of exposure to azole antifungal agents, they suggest considering a class switch to other antifungal agents.