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. 2022 Jun 9;11(6):788.
doi: 10.3390/antibiotics11060788.

Epidemiology, Clinical Characteristics, Risk Factors, and Outcomes of Candidemia in a Large Tertiary Teaching Hospital in Western China: A Retrospective 5-Year Study from 2016 to 2020

Jie Hou  1 , Jin Deng  1 , Ya Liu  1 , Weili Zhang  1 , Siying Wu  1 , Quanfeng Liao  1 , Ying Ma  1 , Mei Kang  1
Affiliations

Epidemiology, Clinical Characteristics, Risk Factors, and Outcomes of Candidemia in a Large Tertiary Teaching Hospital in Western China: A Retrospective 5-Year Study from 2016 to 2020

Jie Hou et al. Antibiotics (Basel). .

Abstract

The aim of this study was to investigate the current status of candidemia and evaluate the clinical characteristics, risk factors and outcomes among different species. We conducted a retrospective study by univariate and multivariate analysis between Candida albicans and non-albicans Candida (NAC) species in a Chinese national medical center from 2016 to 2020. Among the 259 episodes, C. albicans (38.6%) was the leading species, followed by C. tropicalis (24.3%), C. parapsilosis (20.5%), and C. glabrata (12.4%). Most C. albicans and C. parapsilosis were susceptible to nine tested antifungal agents, whereas C. tropicalis showed 30.2~65.9% resistance/non-wild-type to four azoles with great cross-resistance, indicating that fluconazole should not be used for empirical antifungal treatment. In multivariable models, the factor related to an increased risk of NAC was glucocorticoid exposure, whereas gastrointestinal hemorrhage and thoracoabdominal drainage catheters were associated with an increased risk in C. albicans. Subgroup analysis revealed leukemia and lymphoma, as well as glucocorticoid exposure, to be factors independently associated with C. tropicalis in comparison with C. albicans candidemia. No significant differences in 7-day mortality or 30-day mortality were observed between C. albicans and NAC. This study may provide useful information with respect to choosing empirical antifungal agents and exploring differences in molecular mechanisms.

Keywords: Candida albicans; Candida tropicalis; azole resistance; candidemia; non-albicans Candida; risk factors.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the comparative study from 2016 to 2020.
Figure 2
Figure 2
Distribution of Candida species in candidemia from 2016 to 2020 (n = 259).
Figure 3
Figure 3
Change trend of C. albicans vs. non-albicans Candida over the five-year study period (n = 259).
Figure 4
Figure 4
Kaplan–Meier survival curve of patients with C. albicans and non-albicans candidemia. Survival curve for 100 C. albicans vs. 159 non-albicans Candida candidemia (A), 100 C. albicans vs. 63 C. tropicalis candidemia (B), 100 C. albicans vs. 53 C. parapsilosis candidemia (C), 100 C. albicans vs. 32 C. glabrata candidemia (D).
See this image and copyright information in PMC

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