Catheter-related Candida bloodstream infection in intensive care unit patients: a subgroup analysis of the China-SCAN study

BMC Infectious Diseases

Jianguo Li¹  Haibo Qiu⁶  Qiang Fang³  Bingyu Qin²  Wei Cui⁴  Bin Zang⁷  Yan Kang⁵  Zhaohui Du¹  Bo Hu¹ 

[1] Department of Intensive Care Unit, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, China;Department of Intensive Care Unit, Henan Provincial People’s Hospital, Zhengzhou, China;The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China;Department of Intensive Care Unit, The 2nd Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China;Department of Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China;Department of Intensive Care Unit, Nanjing Zhong-da Hospital, Southeast University School of Medicine, Nanjing, China;Department of Intensive Care Unit, Shengjing Hospital, affiliated to China Medical University, Shenyang, China

关键词: Candida albicans;    Candida parapsilosis;    Candidemia;    Catheter related infection;   

Others  :  1122063
DOI  :  10.1186/s12879-014-0594-0

 received in 2014-05-19, accepted in 2014-10-28,  发布年份 2014

【 摘 要 】

Background

In patients hospitalized in intensive care units (ICU), Candida infections are associated with increased morbidity, mortality and costs. However, previous studies reported confused risk factors for catheter-related Candida bloodstream infection (CRCBSI). The objective was to describe the risk factors, microbiology, management and outcomes of CRCBSI in the China-SCAN population.

Methods

Patients with ≥1 Candida-positive peripheral blood culture were selected from the China-SCAN study. Peripheral and catheter blood samples were collected for Candida isolation. Patients with the same strain of Candida in peripheral and catheter blood samples were considered as being with CRCBSI, while patients with Candida-positive peripheral blood cultures only or different strains were considered as non-CRCBSI. Data were collected from the China-SCAN study.

Results

CRCBSI incidence in ICU was 0.03% (29/96,060), accounting for 9.86% of all candidemia observed in ICU (29/294). The proportion of CRCBSI due to Candida parapsilosis reached 33.3%, more than that of Candida albicans (28.6%). In univariate analyses, older age (P = 0.028) and lower body weight (P = 0.037) were associated with CRCBSI. Multivariate analysis showed that the sequential organ failure assessment (SOFA) score was independently associated with CRCBSI (odds ratio (OR) = 1.142, 95% confidence interval = 1.049-1.244, P = 0.002). Catheter removal and immune enhancement therapy were often used for CRCBSI treatment.

Conclusions

In China, CRCBSI was more likely to occur in old patients with low body weight. SOFA score was independently associated with CRCBSI. Candida parapsilosis accounted for a high proportion of CRCBSI, but the difference from non-CRCBSI was not significant.

【 授权许可】

   
2014 Hu et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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