Nineteen years retrospective analysis of epidemiology, antifungal resistance and a nomogram model for 30-day mortality in nosocomial candidemia patients
Frontiers in Cellular and Infection Microbiology,
Год журнала:
2025,
Номер
15
Опубликована: Фев. 3, 2025
Background
The
incidence
of
nosocomial
candidemia
has
increased
in
recently
years,
however,
the
epidemiological
data
remain
insufficient
China.
Methods
A
total
234
patients
were
included
from
Xiamen
University
Zhong
Shan
hospital
between
January
2006
and
October
2024.
Incidence,
species
proportion,
distribution,
antifungal
drug
resistance
was
analyzed.
nomogram
model
for
30-day
morbidity
determined
using
least
absolute
shrinkage
logistic
regression
analysis.
Results
recent
years
(2020:
0.025%,
2021:
0.029%,
2023:0.022%).
dominant
Candida
albicans
(n=99,42.31%),
parapsilosis
(n=47,20.09%),
tropicalis
(n=43,18.38%),
glabrata
(n=31,13.25%).
Departments
with
a
higher
detection
intensive
care
unit
(n=55),
emergency
department
(n=24)
hepatobiliary
surgery
(n=22).
performed
highest
to
azole
(fluconazole:
55.81%,
voriconazole:55.00%
itraconazole:58.14%).
fluconazole,
voriconazole
itraconazole
32.32%,
23.53%
31.31%.
mortality
rate
discharge
reached
52.99%.
205
cases
December
2023
as
training
set,
while
29
candidiasis
2004
validation
set.
Five
independent
factors
,
decreased
albumin,
multiple
organ
dysfunction
syndrome,
solid
tumor
septic
shock
adopted
30-days
candidemia.
In
area
under
curve
0.866
(95%CI:
0.817-0.916),
optimal
cutoff
value
0.617,
sensitivity
80%
specificity
80.4%.
0.808
(95%CI:0.737-0.970),
0.543.
72.7%
83.3%.
Conclusion
risen
years.
remains
primary
species,
is
unit.
exhibits
drugs.
predicting
been
constructed,
risk
including
shock,
tumors,
albumin.
Язык: Английский
Impact of Fluconazole Resistance on the Outcomes of Patients With Candida parapsilosis Bloodstream Infections: A Retrospective Multicenter Study
Clinical Infectious Diseases,
Год журнала:
2025,
Номер
unknown
Опубликована: Янв. 15, 2025
Abstract
Background
This
study
assesses
the
impact
of
fluconazole
resistance
on
30-day
all-cause
mortality
and
1-year
recurrence
in
patients
with
Candida
parapsilosis
bloodstream
infections
(BSI).
Methods
A
multicenter
retrospective
was
performed
at
3
hospitals
Italy
Spain
between
2018
2022.
Adult
positive
blood
cultures
for
C.
who
received
appropriate
targeted
therapy
either
echinocandins
or
were
included.
Results
Among
457
patients,
196
(42.9%)
had
fluconazole-resistant
(FLZR-CP)
BSI
261
(57.1%)
fluconazole-susceptible
(FLZS-CP)
BSI.
All
FLZR-CP
echinocandins,
while
FLZS-CP
(60.5%)
(39.5%).
Unadjusted
rates
28.6%
28.4%
(log-rank
test,
P
=
.998).
In
multivariable
analysis,
increased
associated
age
(adjusted
hazard
ratio
[aHR]
1.03
per
year;
95%
confidence
interval
[CI],
1.01–1.05;
.0005),
solid
tumor
(aHR
1.91;
CI,
1.06–3.46;
.0302),
previous
antifungal
treatment
1.84;
1.12–3.10;
.0192),
septic
shock
2.39;
1.42–4.06;
.0010),
but
not
1.00;
.62–1.63;
.9864)
nor
type
initial
1.46;
.69–3.06;
.3202).
Propensity
score-matched
analysis
showed
no
difference
echinocandin-treated
fluconazole-treated
(HR
0.81;
.37–1.75;
.5915).
However,
a
higher
risk
observed
(odds
ratio,
7.37;
2.11–25.80;
.0018).
Conclusions
Our
results
suggest
that
is
BSI,
though
group.
Язык: Английский
Clinical manifestations and treatment of candidemia caused by different Candida species: a retrospective study
BMC Infectious Diseases,
Год журнала:
2024,
Номер
24(1)
Опубликована: Ноя. 4, 2024
Candidemia
leads
to
higher
mortality
and
longer
hospital-stay.
While
the
studies
about
clinical
manifestations
of
candidemia
caused
by
different
Candida
species
relationship
between
antifungal
drugs
prognosis
were
rarely
performed.
This
retrospective
study
enrolled
all
94
patients
diagnosed
as
from
January
2020
July
2023
in
BTCH.
Demographic
information,
comorbidities,
laboratory
parameters,
medications
collected
analyzed.
C.
albicans
was
most
common
specie
candidemia.
There
no
significant
difference
age,
gender
hospital-mortality
groups.
Higher-level
duration
broad-spectrum
antibiotic
use,
lower
BMI,
hypoalbuminemia,
PN
history
G+
coccemia
conclusive
mortality.
The
C.tropicalis
group
had
SCRE
levels
(F
=
8.40,
P
0.03)
shorter
TTP
5.03,
<
0.01)
than
other
species.
No
distinction
found
groups
including
triazoles
echinocandins
after
7
days
treatment
(χ2
0.05,
0.81).
efficacy
(χ12
1.20,
P1
0.75;
χ22
P2
accounts
among
candida
induecd
candidemia.The
Elder,
hypoproteinemia,
higher-level
support
increase
risks
for
are
same
when
blood
culture
turned
negative
days.
Язык: Английский