Clinical characteristics and outcomes of Candida tropicalis fungemia in patients with hematologic diseases: a single-center retrospective study in China (2018-2024).

BACKGROUND

Candida tropicalis has emerged as a significant non-albicans Candida species, particularly in patients with hematologic diseases. However, large-scale data on the clinical characteristics and outcomes of Candida tropicalis fungemia specifically in this high-risk population remain limited, necessitating further investigation.

OBJECTIVE

To investigate the epidemiology, clinical characteristics, and prognostic risk factors of Candida tropicalis fungemia in hematology patients.

METHODS

A retrospective analysis was conducted on clinical data from 65 patients with Candida tropicalis bloodstream infection, confirmed by blood culture, in the hematology department of the First Affiliated Hospital of Soochow University between January 2018 and December 2024.

RESULTS

Candida tropicalis fungemia accounted for 0.69‰ of cases in our hematology department. All infections occurred in patients with hematologic malignancies, primarily acute leukemia. This pathogen demonstrated notably high resistance rates to fluconazole and voriconazole. The overall mortality rate was 29.2%. Univariate analysis identified sex (male), primary disease status, positive (1,3)-β-D-glucan test, positive procalcitonin test, organ damage, requirement for respiratory support, and the presence of shock as risk factors for mortality. However, multivariate analysis confirmed that only the primary disease status was an independent prognostic factor.

CONCLUSION

Candida tropicalis is a significant pathogen in the hematology setting, particularly among patients with hematologic malignancies, causing bloodstream infections with high mortality. Our findings suggest that effective management of the underlying hematologic disease is crucial for improving patient survival outcomes.