Prevalence, Mortality, Antifungal Resistance, and Risk Factors of Candidemia Among Cancer Patients in a Single Center of Southern China: A 10-Year Retrospective Study.

Abstract

Cancer patients are at a high risk of Candida infections, and candidemia may aggravate the prognosis among patients with cancers. To investigate the incidence, mortality, risk factors, and antifungal resistance of candidemia among cancer patients, 100 inpatients with malignant solid tumors and candidemia in Fujian Province, southern China, during the period from January 2014 through December 2023 were recruited. Among the study subjects, Candida albicans was the predominant Candida species (50%), and the prevalence of candidemia showed an overall tendency towards a slight decline during the study period. Candida tropicalis showed 10.53% prevalence of resistance to fluconazole, voriconazole and itraconazole, while C. albicans, Candida glabrata and Candida parapsilosis were all totally susceptible to fluconazole, voriconazole, itraconazole and amphotericin B. The overall 30-day crude mortality of candidemia was 67% among cancer patients, and there was no significant difference between the mortality due to Candida catheter-related bloodstream infection (CRBSI) and bloodstream infection (BSI) (p = 0.59). Multivariate Cox regression analysis identified that the presence of cardiovascular diseases and use of two to three catheters (OR = 385.064, p = 0.005) increased the risk of candidemia among cancer patients. Our data demonstrate an overall tendency towards a slight decline in the prevalence of candidemia and a high mortality rate of candidemia among cancer patients in southeastern China from 2014 to 2023, and development of cardiovascular diseases and use of two to three catheters may increase the risk of candidemia among cancer patients.