Epidemiology, species distribution, and outcome of nosocomial Candida spp. bloodstream infection in Shanghai: an 11-year retrospective analysis in a tertiary care hospital

Annals of Clinical Microbiology and Antimicrobials

Xiao-Ying Liu¹  En-Qiang Mao²  Er-Zhen Chen²  Yan-Jun Zheng²  Ying Chen²  Zhi-Tao Yang³  Ling Zhu⁴  Lin Wu⁵  Li-Zhong Han⁶  Ting Xie⁷ 

[1] Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China;Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China;Pôle Sino-Français de Recherches en Science du Vivant Et Génomique, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;Department of Emergency, Ruijin North Hospital, Shanghai Jiao Tong University School of Medicine, 201801, Shanghai, China;Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;Emergency Center, Suining Central Hospital, 629000, Suining, Sichuan Province, China;

关键词: Candida spp.;    Bloodstream infection;    Epidemiology;    Species distribution;    Antifungal therapy;    Early treatment;   

DOI  :  10.1186/s12941-021-00441-y

来源: Springer

【 摘 要 】

BackgroundThe incidence of Candida bloodstream infections (BSIs), has increased over time. In this study, we aimed to describe the current epidemiology of Candida BSI in a large tertiary care hospital in Shanghai and to determine the risk factors of 28-day mortality and the impact of antifungal therapy on clinical outcomes.MethodsAll consecutive adult inpatients with Candida BSI at Ruijin Hospital between January 1, 2008, and December 31, 2018, were enrolled. Underlying diseases, clinical severity, species distribution, antifungal therapy, and their impact on the outcomes were analyzed.ResultsAmong the 370 inpatients with 393 consecutive episodes of Candida BSI, the incidence of nosocomial Candida BSI was 0.39 episodes/1000 hospitalized patients. Of the 393 cases, 299 (76.1%) were treated with antifungal therapy (247 and 52 were treated with early appropriate and targeted antifungal therapy, respectively). The overall 28-day mortality rate was 28.5%, which was significantly lower in those who received early appropriate (25.5%) or targeted (23.1%) antifungal therapy than in those who did not (39.4%; P = 0.012 and P = 0.046, respectively). In multivariate Cox regression analysis, age, chronic renal failure, mechanical ventilation, and severe neutropenia were found to be independent risk factors of the 28-day mortality rate. Patients who received antifungal therapy had a lower mortality risk than did those who did not.ConclusionsThe incidence of Candida BSI has increased steadily in the past 11 years at our tertiary care hospital in Shanghai. Antifungal therapy influenced short-term survival, but no significant difference in mortality was observed between patients who received early appropriate and targeted antifungal therapy.

【 授权许可】

CC BY