Liang Chen,1,2 Zeqiang Xie,1,2 Jiyong Jian1,2 

1Clinical Laboratory Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics, Beijing, People’s Republic of China

Correspondence: Jiyong Jian, Clinical Laboratory Medicine, Beijing Shijitan Hospital, Capital Medical University, NO. 10, Tie Yi Road, Yang Fang Dian, Beijing, Haidian District, People’s Republic of China, Email jianjiyong3137@bjsjth.cn

Purpose: We investigated the Epidemiology, risk factors and outcomes of Candida bloodstream infection.
Methods: The electronic laboratory records data of patients with candidemia (2015– 2022) were collected. We used univariate and multivariate logistic regression to determine the risk factors of candidemia.
Results: Of the 134 patients with candidemia, the most prevalent species were Candida albicans (37.2%), followed by Candida glabrata (27.7%), Candida parapsilosis (18.9%), and others. The mean annual incidence was 0.33/1000 admissions. The overall resistance rate of Candida spp. against fluconazole and voriconazole were 4.9% (7/142) and 5.9% (6/101), while Candida tropicalis showed high resistance to fluconazole (38.8%) and voriconazole (27.8%). The 30-day mortality rate was 32.8%. On multivariate analysis, age ≥ 65 (odds ratio [OR] = 3.874, 95% confidence interval [CI]: 1.146, 13.092; P = 0.029), high Acute Physiology and Chronic Health Evaluation II (APACHE II) score (OR = 12.384, 95% CI: 2.963, 51.762; P = 0.001), shock (OR = 3.428, 95% CI: 1.097, 10.719; P = 0.034), initial antifungal therapy (OR = 0.057, 95% CI: 0.011, 0.306; P = 0.001) and White blood cells (OR = 1.129, 95% CI: 1.016, 1.255; P = 0.024) were the independent risk factors with mortality within 30 day in patients with candidemia.
Conclusion: The incidence rate and the mortality rate of candidemia are high, and lower azole susceptibility was found in Candida tropicalis. Age≥ 65 years, Shock, high APACHE II score, Antifungal therapy and White blood cells count were independently associated with 30-day mortality.

Keywords: Candidemia, Epidemiology, Antifungal susceptibility, Mortality, Risk factors