Clinical manifestations and treatment of candidemia caused by different Candida species: a retrospective study.

Abstract

Objective: Candidemia leads to higher mortality and longer hospital-stay. While the studies about the clinical manifestations of candidemia caused by different Candida species and the relationship between the antifungal drugs and prognosis were rarely performed.

Methods: This retrospective study enrolled all 94 patients diagnosed as candidemia from January 2020 to July 2023 in BTCH. Demographic information, comorbidities, laboratory parameters, medications and prognosis were collected and analyzed.

Results: C. albicans was the most common specie of candidemia. There was no significant difference in age, gender and hospital-mortality in different species groups. Higher-level and longer duration of broad-spectrum antibiotic use, lower BMI, hypoalbuminemia, longer duration of PN and history of G⁺ coccemia were conclusive about mortality. The C.tropicalis group had higher SCRE levels (F = 8.40, P = 0.03) and shorter TTP (F = 5.03, P < 0.01) than other species. No distinction was found in different antifungal drugs groups including triazoles and echinocandins after 7 days treatment (χ² = 0.05, P = 0.81). The efficacy was no difference between triazoles and echinocandins in the different species groups. (χ₁² = 1.20, P₁ = 0.75; χ₂² = 0.05, P₂ = 0.81).

Conclusion: C. albicans accounts the most among candida induecd candidemia.The C.tropicalis group had higher SCRE levels and shorter TTP than other groups. Elder, hypoproteinemia, lower BMI, longer duration and higher-level of broad-spectrum antibiotic use, longer PN support and G⁺ coccemia increase risks for candidemia. The efficacy of triazoles and echinocandins are the same when blood culture turned negative in 7 days.