Epidemiology and Risk Factors of Candidemia a 8-Year Retrospective Study from a Teaching Hospital in China.

IF 2.9 3区医学 Q2 INFECTIOUS DISEASES

Infection and Drug Resistance Pub Date : 2024-08-07 eCollection Date: 2024-01-01 DOI:10.2147/IDR.S471171

Liang Chen, Zeqiang Xie, Jiyong Jian

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Abstract

Purpose: We investigated the Epidemiology, risk factors and outcomes of Candida bloodstream infection.

Methods: The electronic laboratory records data of patients with candidemia (2015-2022) were collected. We used univariate and multivariate logistic regression to determine the risk factors of candidemia.

Results: Of the 134 patients with candidemia, the most prevalent species were Candida albicans (37.2%), followed by Candida glabrata (27.7%), Candida parapsilosis (18.9%), and others. The mean annual incidence was 0.33/1000 admissions. The overall resistance rate of Candida spp. against fluconazole and voriconazole were 4.9% (7/142) and 5.9% (6/101), while Candida tropicalis showed high resistance to fluconazole (38.8%) and voriconazole (27.8%). The 30-day mortality rate was 32.8%. On multivariate analysis, age ≥ 65 (odds ratio [OR] = 3.874, 95% confidence interval [CI]: 1.146, 13.092; P = 0.029), high Acute Physiology and Chronic Health Evaluation II (APACHE II) score (OR = 12.384, 95% CI: 2.963, 51.762; P = 0.001), shock (OR = 3.428, 95% CI: 1.097, 10.719; P = 0.034), initial antifungal therapy (OR = 0.057, 95% CI: 0.011, 0.306; P = 0.001) and White blood cells (OR = 1.129, 95% CI: 1.016, 1.255; P = 0.024) were the independent risk factors with mortality within 30 day in patients with candidemia.

Conclusion: The incidence rate and the mortality rate of candidemia are high, and lower azole susceptibility was found in Candida tropicalis. Age≥65 years, Shock, high APACHE II score, Antifungal therapy and White blood cells count were independently associated with 30-day mortality.

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中国一家教学医院的 8 年回顾性研究：念珠菌血症的流行病学和风险因素

目的：我们研究了念珠菌血流感染的流行病学、风险因素和结果：收集了念珠菌血症患者的电子实验室记录数据（2015-2022 年）。我们采用单变量和多变量逻辑回归来确定念珠菌血症的风险因素：在134名念珠菌血症患者中，最常见的菌种是白色念珠菌（37.2%），其次是光滑念珠菌（27.7%）、副丝状念珠菌（18.9%）及其他。年平均发病率为 0.33/1000。念珠菌属对氟康唑和伏立康唑的总体耐药率分别为 4.9%（7/142）和 5.9%（6/101），而热带念珠菌对氟康唑（38.8%）和伏立康唑（27.8%）的耐药率较高。30 天死亡率为 32.8%。多变量分析显示，年龄≥65岁（几率比[OR] = 3.874，95%置信区间[CI]：1.146, 13.0%）的患者死亡率最高：1.146, 13.092; P = 0.029）、急性生理学和慢性健康评价 II（APACHE II）评分高（OR = 12.384, 95% CI: 2.963, 51.762; P = 0.001）、休克（OR = 3.428, 95% CI: 1.097, 10.719; P = 0.034）、初始抗真菌治疗（OR = 0.057, 95% CI: 0.011, 0.306; P = 0.001）和白细胞（OR = 1.129, 95% CI: 1.016, 1.255; P = 0.024）是念珠菌血症患者30天内死亡的独立危险因素：结论：念珠菌血症的发病率和死亡率都很高，热带念珠菌对唑类药物的敏感性较低。年龄≥65岁、休克、APACHE II评分高、抗真菌治疗和白细胞计数与30天内的死亡率密切相关。

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来源期刊

Infection and Drug Resistance Medicine-Pharmacology (medical)

CiteScore

5.60

自引率

7.70%

发文量

826

审稿时长

16 weeks

期刊介绍： About Journal Editors Peer Reviewers Articles Article Publishing Charges Aims and Scope Call For Papers ISSN: 1178-6973 Editor-in-Chief: Professor Suresh Antony An international, peer-reviewed, open access journal that focuses on the optimal treatment of infection (bacterial, fungal and viral) and the development and institution of preventative strategies to minimize the development and spread of resistance.