Scholarlink

Background <p><i>Candida</i> bloodstream infection (BSI) causes substantial morbidity and mortality in hospitalized patients, and its epidemiology may vary across resource-limited settings. We described <i>Candida</i> species distribution in candidemia patients in Yulin, China, and assessed factors associated with species patterns and predictors of 28-day mortality to support risk stratification and clinical management.</p> Methods <p>We retrospectively included patients with a first episode of candidemia at The First People’s Hospital of Yulin (2018–2024), collecting demographic, clinical, laboratory, and treatment data. Factors associated with <i>C. albicans</i> (vs non-albicans) candidemia were evaluated using univariate tests and multivariable logistic regression, and predictors of 28-day mortality were assessed with Cox models and Kaplan–Meier analyses.</p> Results <p>A total of 565 patients were included; 64.1% were male, and the median age was 65 years (IQR, 55–73). <i>C. albicans</i> was the most common species (45.7%, 258/565), while non-albicans <i>Candida</i> accounted for 54.3%, mainly <i>C. glabrata</i> (16.6%), <i>C. tropicalis</i> (16.5%), and the <i>C. parapsilosis</i> complex (15.0%). From 2018 to 2024, the overall number of isolates increased, with a progressive shift toward non-albicans <i>Candida</i> species. Mechanical ventilation was an independent risk factor for <i>C. albicans</i> BSI (OR = 1.748, 95% CI 1.225–2.495). The 28-day mortality rate was 21.9% (124/565). Independent risk factors for 28-day mortality included solid organ malignancy (aHR = 2.429, 95% CI 1.435–4.111), coronary heart disease (aHR = 1.610, 95% CI 1.079–2.403), digestive system diseases (aHR = 1.510, 95% CI 1.048–2.176), clavicular vein catheterization (aHR = 1.666, 95% CI 1.082–2.566), mechanical ventilation (aHR = 2.080, 95% CI 1.297–3.334), and hemodialysis (aHR = 1.724, 95% CI 1.168–2.546). Patients who received antifungal therapy showed higher observed survival than those who did not (log-rank <i>p</i> &lt; 0.001), whereas patients with central venous catheterization showed lower observed survival than those without (log-rank <i>p</i> = 0.009).</p> Conclusions <p>Candidemia in Yulin was mainly caused by <i>C. albicans</i>, with a rising contribution from non-albicans species. Mechanical ventilation was associated with <i>C. albicans</i> candidemia, and gastrointestinal diseases, mechanical ventilation, and hemodialysis were linked to higher 28-day mortality. Enhanced risk-based surveillance and timely guideline-concordant management may improve outcomes, but prospective studies are needed to confirm these findings.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Epidemiology, risk factors, and mortality of Candida bloodstream infection in Yulin, China: a 7-year retrospective study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年1月30日

查看全文
  • Chan Liang,
  • Ye Xue,
  • Meixiang Qin,
  • Xinru Xie,
  • Yi Zeng,
  • Xuefu Tang,
  • Danping Qiu,
  • Taijie Li

摘要

Background

Candida bloodstream infection (BSI) causes substantial morbidity and mortality in hospitalized patients, and its epidemiology may vary across resource-limited settings. We described Candida species distribution in candidemia patients in Yulin, China, and assessed factors associated with species patterns and predictors of 28-day mortality to support risk stratification and clinical management.

Methods

We retrospectively included patients with a first episode of candidemia at The First People’s Hospital of Yulin (2018–2024), collecting demographic, clinical, laboratory, and treatment data. Factors associated with C. albicans (vs non-albicans) candidemia were evaluated using univariate tests and multivariable logistic regression, and predictors of 28-day mortality were assessed with Cox models and Kaplan–Meier analyses.

Results

A total of 565 patients were included; 64.1% were male, and the median age was 65 years (IQR, 55–73). C. albicans was the most common species (45.7%, 258/565), while non-albicans Candida accounted for 54.3%, mainly C. glabrata (16.6%), C. tropicalis (16.5%), and the C. parapsilosis complex (15.0%). From 2018 to 2024, the overall number of isolates increased, with a progressive shift toward non-albicans Candida species. Mechanical ventilation was an independent risk factor for C. albicans BSI (OR = 1.748, 95% CI 1.225–2.495). The 28-day mortality rate was 21.9% (124/565). Independent risk factors for 28-day mortality included solid organ malignancy (aHR = 2.429, 95% CI 1.435–4.111), coronary heart disease (aHR = 1.610, 95% CI 1.079–2.403), digestive system diseases (aHR = 1.510, 95% CI 1.048–2.176), clavicular vein catheterization (aHR = 1.666, 95% CI 1.082–2.566), mechanical ventilation (aHR = 2.080, 95% CI 1.297–3.334), and hemodialysis (aHR = 1.724, 95% CI 1.168–2.546). Patients who received antifungal therapy showed higher observed survival than those who did not (log-rank p < 0.001), whereas patients with central venous catheterization showed lower observed survival than those without (log-rank p = 0.009).

Conclusions

Candidemia in Yulin was mainly caused by C. albicans, with a rising contribution from non-albicans species. Mechanical ventilation was associated with C. albicans candidemia, and gastrointestinal diseases, mechanical ventilation, and hemodialysis were linked to higher 28-day mortality. Enhanced risk-based surveillance and timely guideline-concordant management may improve outcomes, but prospective studies are needed to confirm these findings.