Wuhan University, Renmin Hospital, Department of Critical Care Medicine, Wuhan, Hubei Province, People's Republic of China.
Wuhan University, Renmin Hospital, Department of Respiratory and Critical Care Medicine, Wuhan, Hubei Province, People's Republic of China.
Rev Inst Med Trop Sao Paulo. 2021 Mar 24;63:e20. doi: 10.1590/S1678-9946202163020. eCollection 2021.
We analyzed the clinical features and risk factors of candidemia due to C. parapsilosis (n=104) in the intensive care unit of a tertiary hospital over six years. This was a monocentric, retrospective study of candidemia, conducted from January 2013 to March 2019. Epidemiological characteristics, clinical features, invasive procedures, laboratory data and outcomes of 267 patients with candidemia were analyzed to determine risk factors of candidemia due to C. parapsilosis. Sixty-three cases of C. albicans and 204 cases of non-C. albicans Candida (NCAC) species were included, the latter was composed of 104 cases of C. parapsilosis and 100 cases of non-C. albicans species (46 cases of C. tropicalis, 22 cases of C. glabrata, 23 cases of C. guilliermondii, 5 cases of C. krusei and 4 cases of C. lusitaniae), suggesting that C. parapsilosis was the predominant Candida species isolated from cases of candidemia. A binary multivariate logistic regression analysis showed that APACHE II scores, central venous catheterization and the use of broad-spectrum antibiotics were closely related to C. parapsilosis candidemia, with OR values of 1.159, 3.913 and 2.217, respectively. In conclusion, we found that C. parapsilosis was the main pathogen among the NCAC candidemia in the ICU patients. APACHE II scores, central venous catheterization and the use of broad-spectrum antibiotics were independent risk factors for the occurrence of C. parapsilosis candidemia, which may provide data to support the early introduction of anti-fungal therapy.
我们分析了六年内在一家三级医院重症监护病房中由近平滑念珠菌引起的念珠菌血症的临床特征和危险因素（n=104）。这是一项关于念珠菌血症的单中心回顾性研究，于 2013 年 1 月至 2019 年 3 月进行。分析了 267 例念珠菌血症患者的流行病学特征、临床特征、侵袭性操作、实验室数据和结局，以确定由近平滑念珠菌引起的念珠菌血症的危险因素。纳入 63 例白念珠菌和 204 例非白念珠菌念珠菌（NCAC）种，后者由 104 例近平滑念珠菌和 100 例非白念珠菌种（46 例热带念珠菌、22 例光滑念珠菌、23 例近平滑念珠菌、5 例克柔念珠菌和 4 例葡萄牙念珠菌）组成，表明近平滑念珠菌是从念珠菌血症病例中分离出的主要念珠菌种。二元多变量逻辑回归分析显示，APACHE II 评分、中心静脉置管和广谱抗生素的使用与近平滑念珠菌血症密切相关，OR 值分别为 1.159、3.913 和 2.217。总之，我们发现近平滑念珠菌是 ICU 患者中 NCAC 念珠菌血症的主要病原体。APACHE II 评分、中心静脉置管和广谱抗生素的使用是近平滑念珠菌血症发生的独立危险因素，这可能为早期引入抗真菌治疗提供数据支持。
