Invasive candidiasis in intensive care units in China: Risk factors and prognoses of Candida albicans and non–albicans Candida infections

Abstract

To investigate the risk factors and prognoses of patients with invasive Candida albicans and non-albicans Candida (NAC) infection in intensive care units (ICUs) in China. Between November 2009 and April 2011, we performed a prospective study of critically ill patients with invasive Candida infection from 67 ICUs across China to compare the risk factors and mortality between patients with Calbicans and NAC infection. There were 306 patients with proven invasive Candida; 244 cases (a total 389 Candida isolates) were sent to laboratory for strain identification (Calbicans, 40.1%; NAC, 59.9%). More patients admitted for surgery or trauma had NAC infection than C albicans infection. C albicans infection was more common in patients with subclavian vein catheters or peritoneal drainage tubes. Compared with patients with Calbicans infection, patients with NAC infection had longer antifungal therapy (P < .001), longer ICU (P = .004) or hospital stay (P = .002), and slightly higher mortality (38.4% vs 29.6%), but the difference was not significant (P = .17). C albicans remains the most common pathogen in candidiasis in critical care patients. However, the number of NAC infections exceeded Calbicans infections. Compared with patients with Calbicans infection, patients with NAC infection had heavier disease burdens.