Epidemiology, risk factors and outcomes of <i>Candida albicans vs.</i> non-<i>albicans</i> candidaemia in adult patients in Northeast China

Zhang, Wei; Song, Xingpeng; Wu, Hao; Zheng, Rui

doi:10.1017/s0950268819001638

Cited by 32 publications

(37 citation statements)

References 38 publications

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“…C. glabrata has already been found to be more frequent in the elderly in previous studies, and there is not a clear explanation for this finding [ 30 , 39 ]. Regarding TPN, the data in the literature are so far inconclusive—there are studies showing the association of TPN with both C. albicans and non-albicans Candida species [ 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Candidemia: Three-Year Results from a Croatian Tertiary Care Hospital

Mareković

Pleško

Vranješ

et al. 2021

JoF

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Invasive candidosis is the most common invasive fungal infection in hospitalized patients and is associated with a high mortality rate. This is the first study from a Croatian tertiary care hospital describing epidemiology, risk factors and species distribution in patients with candidemia. A three-year retrospective observational study, from 2018 to 2020, was performed at the University Hospital Centre Zagreb, Zagreb, Croatia. A total of 160 patients with candidemia (n = 170 isolates) were enrolled. Candidemia incidence increased from 0.47 to 0.69 per 1000 admissions in 2018 and 2020, respectively. Ninety-five patients (58.38%) were in the intensive care unit. The main risk factors for candidemia were central venous catheter (CVC) (84.38%), previous surgical procedure (56.88%) and invasive mechanical ventilation (42.50%). Candida albicans was identified in 43.53% of isolates, followed by C. parapsilosis (31.76%) and C. glabrata (12.36%), C. krusei (5.29%), C. tropicalis (2.35%) and C. lusitaniae (2.35%). The study discovered a shift to non-albicansCandida species, particularly C. parapsilosis, and made it possible to determine the main tasks we should focus on to prevent candidemia in the hospital, these being mainly infection control measures directed towards prevention of catheter-related bloodstream infections, specifically comprising hand hygiene and CVC bundles of care. The potential benefit of fluconazole prophylaxis in certain populations of surgical patients could also be considered.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of Candidemia: Three-Year Results from a Croatian Tertiary Care Hospital

Mareković

Pleško

Vranješ

et al. 2021

JoF

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“…The microbiological laboratory methods for blood culture, Candida species identification, and antifungal susceptibility testing were performed as previously described [13]. The antifungal susceptibilities of the antifungal agents were evaluated according to clinical breakpoints (CBPs) recommended by the Clinical Laboratory Standards Institute (CLSI) [14] or European Committee on Antimicrobial Susceptibility Testing (EUCAST) [15].…”

Section: Microbiological Analysismentioning

confidence: 99%

Epidemiology, species distribution, and predictive factors for mortality of candidemia in adult surgical patients

Zhang

Song

et al. 2020

BMC Infect Dis

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Background: We evaluated the epidemiology, clinical characteristics, microbiology, outcomes, and risk factors for mortality of candidemia in adult surgical patients in Shenyang from 2012 to 2018. Methods: We designed a retrospective observational study of adult patients with candidemia in a teaching hospital including three hospital campuses. Data regarding clinical and demographic characteristics were collected from the patient's medical records. Results: Of the 236 cases of candidemia, 172 (72.9%) were identified in surgical patients, including 146 (84.9%) general surgeries, 11 (6.4%) urologic surgeries, 6 (3.5%) thoracic surgeries, and others. Higher proportions of solid tumors, total parenteral nutrition, the presence of a urinary catheter, and the presence of a gastric tube were observed in surgical patients with candidemia versus non-surgical ones, whereas the percentages of hematological malignancy, diabetes mellitus, and renal replacement therapy were relatively lower in surgical patients. Renal failure, leukopenia, and thrombocytopenia were less common laboratory findings in surgical patients with candidemia than compared to non-surgical ones. Among surgical patients with candidemia, Candida parapsilosis was the predominant species (43%), followed by C. albicans (33.7%), C. glabrata (11%), C. tropicalis (8.1%), and others (4.1%). Overall susceptibility, susceptible dose dependent or intermediate susceptibility, and resistance to fluconazole were detected in 73.3, 19.8, and 3.5% Candida isolates from surgical patients, respectively, but no resistance to amphotericin B was observed. Overall, the 30-day mortality in surgical patients was 19.2%. At multivariable analysis, independent risk factors for death in surgical patients with candidemia were ICU stay, thrombocytopenia, and C. albicans infection. Conclusions: Surgical patients account for the majority of candidemia cases. Among patients with recent surgery, risk factors for species distribution, antifungal sensitivity patterns of Candida isolates causing candidemia, and independent risk factors for mortality should be evaluated and considered for a better outcome in the antifungal treatment.

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“…In previous studies, some differences have been reported between C. albicans and NAC candidemia with regard to the clinical characteristics and prognostic factors. 7–11 However, several limitations are shown as follows: (1) One study identified that the presence of a urethral catheter was an independent risk factor for C. albicans candidemia, 10 and glucocorticosteroids and CVC were independent risk factors for NAC candidemia in another study. 11 However, whether these clinical features are significantly different between these two groups remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Clinical Features, Strain Distribution, Antifungal Resistance and Prognosis of Patients with Non-albicans Candidemia: A Retrospective Observational Study

Liu¹,

Zhong²,

Zhou³

et al. 2021

IDR

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Purpose Candida albicans ( C. albicans ) candidemia has been well reported in previous studies, while research on non -albicans Candida (NAC) bloodstream infections remains poorly explored. Therefore, the present study aimed to investigate the clinical characteristics and outcomes of patients with NAC candidemia. Patients and Methods We recruited inpatients with candidemia from January 2013 to June 2020 in a tertiary hospital for this retrospective observational study. Results A total of 301 patients with candidemia were recruited in the current study, including 161 (53.5%) patients with NAC candidemia. The main pathogens in NAC candidemia were Candida tropicalis ( C. tropicalis ) (23.9%), Candida parapsilosis (15.6%) and Candida glabrata (10.3%). Patients with NAC candidemia had more medical admissions ( P =0.034), a higher percentage of hematological malignancies ( P =0.007), a higher frequency of antifungal exposure ( P =0.012), and more indwelling peripherally inserted central catheters ( P =0.002) than those with C. albicans candidemia. In a multivariable analysis, prior antifungal exposure was independently related to NAC candidemia (adjusted odds ratio [aOR], 0.312; 95% confidence interval [CI], 0.113–0.859). Additionally, NAC was obviously resistant to azoles, especially C. tropicalis had a high cross-resistance to azoles. However, no significant differences were noted in the mortality rates at 14 days, 28 days and 60 days between these two groups. Conclusion NAC is dominant in candidemia, and prior antifungal exposure is an independent risk factor. Of note, although the outcomes of NAC and C. albicans candidemia are similar, drug resistance to specific azoles as well as cross-resistance frequently occurs in patients with NAC candidemia, and this drug resistance deserves attention in clinical practice and further in-depth investigation.

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Epidemiology, risk factors and outcomes of Candida albicans vs. non-albicans candidaemia in adult patients in Northeast China

Cited by 32 publications

References 38 publications

Epidemiology of Candidemia: Three-Year Results from a Croatian Tertiary Care Hospital

Epidemiology of Candidemia: Three-Year Results from a Croatian Tertiary Care Hospital

Epidemiology, species distribution, and predictive factors for mortality of candidemia in adult surgical patients

Clinical Features, Strain Distribution, Antifungal Resistance and Prognosis of Patients with Non-albicans Candidemia: A Retrospective Observational Study

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