Abstract
Background: Invasive fungal infection (IFI) is one of the most common nosocomial infections. However, data on the epidemiology of IFI and susceptibility to antifungal agents in China are quite limited, and in particular, no current data exist on the microbiological, and clinical characteristics of IFI patients in Northeast China.Objectives: The purpose of this study was to provide a retrospective review of the clinical characteristics, laboratory test results, and risk factor predictions of inpatients diagnosed with IFI. Multivariate regression analysis was used to assess prognostic factors associated with the mortality of these patients.Methods: We retrospectively analyzed the results from 509 patients with IFI extracted from the First Hospital of China Medical University from January 2013 to January 2018.Results: Neutrophil numbers, total bilirubin, length of stay in the ICU, renal failure, use of immunosuppressants within the past 30 days, stomach tube placement and septic shock were risk factors for death from IFI. Recent surgery (within 2 weeks) and drainage tube placement did not increase mortality in these IFI patients. Increased serum levels of PCT (AUC 0.601, 95% CI 0.536–0.665, P = 0.003) and CRP (AUC 0.578, 95% CI 0.512–0.644, P = 0.020) provided effective predictors of 30-day mortality rates.Conclusions: We report for the first time epidemiological data on invasive fungal infections in Northeast China over the past 5 years. Despite the limited available clinical data, these findings will greatly aid clinical health care workers with regard to the identification, prevention, and treatment of IFI in hospitalized patients.
Highlights
Invasive fungal infection (IFI) is one of the most common nosocomial bloodstream infections (Bassetti et al, 2016; Bosch et al, 2016) and may result in invasive diseases in patients with various underlying diseases or other host factors
We performed a retrospective review as a means to partially elucidate the microbiological and clinical characteristics of IFI patients in Northeast China, as well as to aid in the prognosis and identify related risk factors associated with this condition
The most frequent infection agent in our sample was Candida parapsilosis (177/509, 34.8%), followed by Candida guilliermondii (136/509, 26.7%), Candida albicans (94/509, 18.5%), Candida glabrata (41/509, 8.1%), Candida tropicalis (39/509, 7.7%), and Cryptococcus neoformans (14/509, 2.8%), with low rates of incidence obtained for the remaining infections, which included those caused by Candida krusei (5/509), Candida lusitaniae (2/509) and Candida streptococcus (1/509) (Figure 1A)
Summary
Invasive fungal infection (IFI) is one of the most common nosocomial bloodstream infections (Bassetti et al, 2016; Bosch et al, 2016) and may result in invasive diseases in patients with various underlying diseases or other host factors. We performed a retrospective review as a means to partially elucidate the microbiological and clinical characteristics of IFI patients in Northeast China, as well as to aid in the prognosis and identify related risk factors associated with this condition. The goals of this study were to (1) record the fungal species distribution and drug resistance of blood- and sterile body fluid-isolated strains as an approach to describe the clinical features of IFI, (2) describe the clinical features of IFI in patients with bacterial infections, and (3) determine the risk factors associated with mortality and prognostic factors. Data on the epidemiology of IFI and susceptibility to antifungal agents in China are quite limited, and in particular, no current data exist on the microbiological, and clinical characteristics of IFI patients in Northeast China
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