Clinical characteristics and risk factors for death in patients with Candida bloodstream infection in Intensive Care Unit.

Abstract

To analyze the distribution of pathogens and risk factors of mortality in Candida bloodstream infection patients in Intensive Care Unit (ICU). The clinical data, infection relevant indexes, and prognosis of patients with Candida bloodstream infection in ICU of Xiangya Hospital of Central South University from January 2016 to December 2020 were retrospectively collected. The distribution of pathogenic bacteria and clinical characteristics of patients with Candida bloodstream infection were analyzed. The patients were assigned into a death group and a survival group according to their survival status, and single factor analysis and logistic regression analysis were used to analyze risk factors for death. A total of 80 patients with Candida bloodstream infection were enrolled, with the highest infection rate (36.3%) of Candidaalbicans. According to the drug sensitivity, all kinds of Candidas were wide type and relatively sensitive to amphotericin B. Candidaalbicans was highly sensitive to fluconazole, itraconazole, and voriconazole (≥96.6%), while non-Candidaalbicans were more resistant to fluconazole, itraconazole, and voriconazole. The overall mortality rate was 36.3%. Univariate analysis showed that the risk factors for the death of patients with Candida bloodstream infection were acute physiology and chronic health evaluation II (APACHE II) score≥20, diabetes mellitus, and mechanical ventilation. Logistic regression analysis showed that the APACHE II score≥20 was an independent risk factor for the death of patients with Candida bloodstream infection (OR=0.220, 95% CI 0.078 to 0.619, P=0.004). The most common strain of Candida bloodstream infection in ICU patients is Candidaalbicans. The APACHE II score≥20 is an independent risk factor for the death of patients with Candida bloodstream infection.