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Войти в исследования Infection and drug resistance · 2026
Clinical Characteristics and Risk Factors for Mortality in Candidemia: A Retrospective Single-Center Study in China.
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Zhou Sihai, Zhang Xin, Yuan Kaixuan, Ling Yong, Zhang Jiahuan, Tian Benshun, Zhang Xiao
Аннотация
PURPOSE: Candidemia is a major cause of hospital-acquired bloodstream infections and is associated with high mortality. This study evaluated clinical characteristics, pathogen distribution, antifungal susceptibility, and factors associated with 28-day outcome in patients with candidemia.
METHODS: We retrospectively analyzed 169 patients with confirmed candidemia at Guangdong Provincial People's Hospital from January 2021 to December 2023. Patients were classified as survivors (n = 81) or non-survivors (n = 88) according to 28-day outcome. Species distribution, time to positivity (TTP), antifungal susceptibility, clinical features, and prognostic factors were compared. Variables significant in univariate analysis were entered into a multivariable logistic regression model.
RESULTS: Most patients were admitted to the intensive care unit (70.41%), and the 28-day mortality rate was 52.07%. The main causative species were Candida albicans (38.46%), Candida parapsilosis (27.22%), Candida glabrata (15.98%), and Candida tropicalis (15.98%). TTP differed significantly among species; C. tropicalis showed the shortest median TTP (18.73 h), whereas C. parapsilosis and C. glabrata showed longer TTPs (38.34 h and 37.15 h, respectively; P < 0.0001). C. tropicalis showed high resistance rates to fluconazole and voriconazole, at 33.33% and 37.04%, respectively. Univariate analysis showed that age, coronary heart disease, respiratory disease, concomitant bacterial bloodstream infections, septic shock, APACHE II score, catheter insertion, mechanical ventilation, glucocorticoid use, antifungal treatment within 48 h, and antifungal therapy duration ≥14 days were associated with 28-day mortality. Multivariate logistic regression further demonstrated that only antifungal therapy lasting ≥14 days emerged as an independent risk factor for 28-day mortality.
CONCLUSION: Candidemia entails severe infection and poor prognosis, with C. albicans predominating. Clinicians should maintain vigilant monitoring and interventions targeting identified risks while tracking evolving resistance patterns.
METHODS: We retrospectively analyzed 169 patients with confirmed candidemia at Guangdong Provincial People's Hospital from January 2021 to December 2023. Patients were classified as survivors (n = 81) or non-survivors (n = 88) according to 28-day outcome. Species distribution, time to positivity (TTP), antifungal susceptibility, clinical features, and prognostic factors were compared. Variables significant in univariate analysis were entered into a multivariable logistic regression model.
RESULTS: Most patients were admitted to the intensive care unit (70.41%), and the 28-day mortality rate was 52.07%. The main causative species were Candida albicans (38.46%), Candida parapsilosis (27.22%), Candida glabrata (15.98%), and Candida tropicalis (15.98%). TTP differed significantly among species; C. tropicalis showed the shortest median TTP (18.73 h), whereas C. parapsilosis and C. glabrata showed longer TTPs (38.34 h and 37.15 h, respectively; P < 0.0001). C. tropicalis showed high resistance rates to fluconazole and voriconazole, at 33.33% and 37.04%, respectively. Univariate analysis showed that age, coronary heart disease, respiratory disease, concomitant bacterial bloodstream infections, septic shock, APACHE II score, catheter insertion, mechanical ventilation, glucocorticoid use, antifungal treatment within 48 h, and antifungal therapy duration ≥14 days were associated with 28-day mortality. Multivariate logistic regression further demonstrated that only antifungal therapy lasting ≥14 days emerged as an independent risk factor for 28-day mortality.
CONCLUSION: Candidemia entails severe infection and poor prognosis, with C. albicans predominating. Clinicians should maintain vigilant monitoring and interventions targeting identified risks while tracking evolving resistance patterns.