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Chinese Journal of Mycology 2020, Vol. 15  Issue (3): 154-160.

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Clinical characteristics and pathogen of patients with candidemia

ZHANG Wen1, LUO Ying1, GUO Cheng-jie1, XU Ying-chun2, XIAO Meng2, LEI Cheng-bin1, ZHAO Yan1, BI Lei1   

  1. 1. Department of Clinical Laboratory, Zibo Central Hospital, Zibo 255036, China;
    2. Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China
  • Received:2019-03-25 Online:2020-06-28 Published:2020-06-28

Abstract:

Objective To explore clinical features, pathogen distribution, antifungal resistance and prognosis of patients with candidiamia. Methods The clinical data of inpatients with candidemia from January 2011 to December 2018 in Zibo Central Hospital were retrospectively studied, and the risk factors, clinical features, species distribution, drug sensitivity and clinical outcomes were described and analyzed. Results The inpatients with candidemia were mainly from ICU (35.9%), and most of them were elderly patients (>60 years old, 75.7%). Candida albicans (40.8%) were the primary species, followed by C. tropicalis (20.4%), C. parapsilosis (20.4%), C. glabrata (10.7%) and C. krusei (3.9%). The separation rate of C. albicans showed the tendency of firstly increased and then decreased from 2011 to 2018, and non-albicans candidemia had risen in recent years. Azole resistance mainly arised in C. tropicalis and C. glabrata, and the sensitivity of C. albicans and C. parapsilosis to azole also declined. The 30-day crude mortality rate was 39.8%. Multivariate regression analysis revealed that agedness (OR=1.091, =0.001) and diabetes (OR=9.709, P=0.005) were independent risk factors, and targeted antifungal therapy (OR=0.142, P=0.008) could improve the prognosis of patients. Conclusion The incidence of candidemia can be reduced by treating basic diseases and reducing invasive operations in high-risk hospitalized patients, and the prognosis of patients can be improved by timely and targeted application of antifungal drugs.

Key words: candidemia, risk factors, antifungal susceptibility test, prognosis

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