Epidemiology, species distribution and outcome of nosocomial Candida spp.bloodstream infection in Shanghai

Yang, Zhitao; Lin, Wei; Liu, Xiaoying; Zhou, Min; Li, Jie; Wu, Jiayin; Cai, Yong; Mao, Enqiang; Chen, Erzhen; Lortholary, Olivier

doi:10.1186/1471-2334-14-241

Cited by 64 publications

(58 citation statements)

References 48 publications

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“…In line with the literature, the prevalence of C. non-albicans spp is increasing in critically ill surgical patients 35. Our patients showed a high prevalence of immunosuppression following cancer, which was the major cause of admission for emergency surgery.…”

Section: Discussionsupporting

confidence: 88%

Intra-abdominalCandidaspp infection in acute abdomen in a quality assurance (QA)-certified academic setting

et al. 2016

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AimsTo evaluate the contribution of light microscopy to detecting Candida spp infection in patients with complicated intra-abdominal infections (IAIs) admitted for acute abdomen to a quality assurance (QA)-certified surgical emergency ward.MethodsWe conducted a retrospective study (2008–2012) of 809 abdominal intraoperative or biopsy tissue specimens obtained from patients admitted with acute abdomen and microbiological samples positive for Candida spp. Demographic data, mortality, comorbidities, specimen type, microscopy results, special histological staining performed, antimicrobial therapy were collected and analysed. Any comments at the multidisciplinary team meeting was recorded in minutes of and approved.ResultsSixty-six patients with complicated IAIs due to Candida spp were identified (39 male, 27 female, mean±SD age 75±20 years). Candida albicans was isolated in 35 cases and Candida non-albicans spp in 31 cases. Candida spp were isolated from blood in 50% of all selected microbiological specimens. Patients were stratified according to Candida spp (albicans vs non-albicans), underlying cancer disease and no previous antimicrobial administration, and a positive correlation with C. albicans isolation was found (p=0.009 and p=0.048, respectively). Out of 41 cases with microscopic evaluation, we identified yeast forms, pseudohyphae or both, indicative of Candida spp, in 23. Identification of Candida spp in histological specimens was higher in C. albicans cases than in C. non-albicans cases (73% vs 37.5%). Microscopy allowed prompt treatment of all patients.ConclusionsLight microscopy still has great diagnostic significance, being a solid QA step. It provides rapid information and clues in patients who may harbour impaired defence mechanisms, concurrent chronic conditions and/or cancer.

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Section: Discussionsupporting

confidence: 88%

Intra-abdominalCandidaspp infection in acute abdomen in a quality assurance (QA)-certified academic setting

et al. 2016

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“…Likewise, we found C. parapsilosis to be the most prevalent NAC species (38.3%) which accords with a report from Mexico of 37.9% in 398 patients of all ages during a 3-year surveillance program from five hospitals [23]. Moreover, there are several other reports of C. parapsilosis as the most frequent NAC species (20–25%) from blood cultures in Spain [5, 19], Italy [15], Latin America [24] and Shanghai, China [9, 25]. The second most common NAC spp.…”

Section: Discussionsupporting

confidence: 75%

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

Zhang

Song

et al. 2019

Epidemiol. Infect.

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This study aimed to evaluate the clinical characteristics, risk factors and outcomes of adult patients with candidaemia caused by C. albicans vs. non-albicans Candida spp. (NAC). All adult hospitalised cases of candidaemia (2012–2017) at a tertiary hospital in Shenyang were included in the retrospective study, and a total of 180 episodes were analysed. C. parapsilosis was the most frequently isolated species (38.3%), followed by C. albicans (35.6%), C. glabrata (13.9%), C. tropicalis (10%) and others (2.2%). As initial antifungal therapy, 75.0%, 3.9%, 5.6% and 2.2% of patients received fluconazole, caspofungin, micafungin and voriconazole, respectively. Multivariate analyses revealed that total parenteral nutrition was associated with an increased risk of NAC bloodstream infections (BSI) (OR 2.535, 95% CI (1.066–6.026)) vs. C. albicans BSI. Additionally, the presence of a urinary catheter was associated with an increased risk of C. albicans BSI (OR 2.295 (1.129–4.666)) vs. NAC BSI. Moreover, ICU stay (OR 4.013 (1.476–10.906)), renal failure (OR 3.24 (1.084–9.683)), thrombocytopaenia (OR 7.171 (2.152–23.892)) and C. albicans (OR 3.629 (1.352–9.743)) were independent risk factors for candidaemia-related 30-day mortality, while recent cancer surgery was associated with reduced mortality risk (OR 26.479 (2.550–274.918)). All these factors may provide useful information to select initial empirical antifungal agents.

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“…In our study, ICU stay, central venous catheterization, mechanical ventilation, length of hospitalization, number of comorbidities, severe sepsis and septic shock were identified as predictors of mortality in patients with candidemia. These results are in agreement with previously published studies that reported risk factors for mortality in patients with candidemia [4,16,20,28,[31][32][33].…”

Section: Discussionsupporting

confidence: 93%

Characteristics and clinical outcomes of patients with Candida bloodstream infections in a tertiary care hospital in Jordan

Ababneh

Abu-Bdair

Mhaidat

et al. 2017

J Infect Dev Ctries

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Introduction: Candida species are important causes of bloodstream infections, accounting for significant morbidity and mortality in hospitalized patients. Methodology: A retrospective observational study was conducted in an academic tertiary hospital of Jordan. The medical records of patients hospitalized over a ten-year period. were reviewed and patients with candidemia were identified. Data analysis included the infecting Candida species, resistance to antifungals, and risk factors associated with mortality. Results: A total of 158 cases of candidemia were identified, with an overall incidence rate of 0.48 episodes/1,000 admissions. The proportion of candidemia caused by Candida albicans (44.3%) was higher than that of candidemia caused by non-albicans Candida species (42.4%). Exposure to antibiotic therapy before hospitalization was the only independent factor associated with non-albicans Candida infection (OR 2.454; p = 0.033). The overall crude 30-day mortality was 38.7%. Central venous catheterization (OR 0.255; p = 0.026), mechanical ventilation (OR 0.162; p = 0.003), severe sepsis and septic shock (OR = 0.073; p = 0.008), admission to intensive care unit (OR 0.78; p = 0.001), C. albicans (OR 0.235; p = 0.018), length of stay (OR 1.057; p = 0.001), number of comorbidities (OR 0.580; p = 0.008) were independent risk factors for 30-day mortality. Conclusion: This study identified several risk factors associated with blood stream infections caused by Candida over 10-years period. Continuous surveillance programs to monitor such types of infection are of great value to antimicrobial stewardship programs.

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Epidemiology, species distribution and outcome of nosocomial Candida spp.bloodstream infection in Shanghai

Cited by 64 publications

References 48 publications

Intra-abdominalCandidaspp infection in acute abdomen in a quality assurance (QA)-certified academic setting

Intra-abdominalCandidaspp infection in acute abdomen in a quality assurance (QA)-certified academic setting

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

Characteristics and clinical outcomes of patients with Candida bloodstream infections in a tertiary care hospital in Jordan

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