关键词: 念珠菌, 血流感染, 临床特征, 危险因素

Abstract: Objective To explore the clinical features of Candida bloodstream infection. Methods The clinical data of 62 patients diagnosed with Candida bloodstream infection in our hospital from January 2017 to December 2021 were collected, and the distribution of pathogen, clinical characteristics and risk factors of death were analyzed. Results A total of 65 strains of fungi were isolated from 62 patients with Candida bloodstream infection, mainly distributed in the intensive care unit (33 strains), urology (7 strains) and hematology (6 strains) departments; the strains were Candida albicans (29.2%), Candida glabrata (26.2%), Candida parapsilosis (21.5%), and Candida tropicalis (18.5%), and the overall non-susceptibility rate to fluconazole was 38.5%. Among 62 patients with Candida bloodstream infection 34 died, and the mortality rate was 54.8%; Univariate analysis showed that admission to intensive care unit, mechanical ventilation, combined lung infection, severe hypoalbuminemia, and no antifungal therapy within 48 hours after positive blood culture were associated with mortality (P<0.05). Logistic regression analysis showed that severe hypoalbuminemia(OR=7.924,95% CI 1.851~34.599,P=0.006) and failure to initiate antifungal therapy within 48 hours after the initial blood culture report(OR=6.828,95% CI 1.377~33.852,P=0.019) were independent risk factors for death. Non-albicans Candida infection was the main, and severe hypoalbuminemia was an independent risk factor for death in patients with Candida bloodstream infection. Early antifungal therapy was important for patient prognosis. Conclusion Candida bloodstream infection patients were characterized by multiple comorbidities and high mortality.

Key words: Candida, bloodstream infection, clinical features, risk factors