Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Mycoses. 2022 Apr;65(4):473-480. doi: 10.1111/myc.13429. Epub 2022 Feb 23.
Candida tropicalis is the most common non-albicans Candida species found in Asia-Pacific countries, including Thailand. The pathogen is known for its great virulence, which causes a high case-fatality rate. Associations between case fatality and patient characteristics, infectious disease unit consultation and EQUAL Candida score were investigated.
This retrospective cohort study was conducted with 160 cases of C. tropicalis bloodstream infection between 2015 and 2019 at a single, large, tertiary centre in Thailand. Clinical characteristics, clinical presentations, patient outcomes (30-day case-fatality rate) and independent predictive factors were analysed.
The 30-day case-fatality rate was 68.1%. The median of the EQUAL Candida score was 8. Independent factors for the prediction of case fatality were septic shock (hazard ratio, 1.84), the use of mechanical ventilation (hazard ratio, 2.03) and the EQUAL Candida score (hazard ratio, 0.75).
The predictive factors for 30-day case fatality were septic shock, mechanical ventilation use and the EQUAL Candida score. It is recommended that the EQUAL score be considered for patients infected with C. tropicalis candidaemia to reduce the case-fatality rate.
热带假丝酵母菌是亚太国家（包括泰国）最常见的非白假丝酵母菌。该病原体具有很强的毒力，导致高病死率。本研究调查了病死率与患者特征、感染病科会诊和 EQUAL 假丝酵母菌评分之间的关系。
本回顾性队列研究纳入了 2015 年至 2019 年期间在泰国一家大型三级医院发生的 160 例热带假丝酵母菌血流感染病例。分析了临床特征、临床表现、患者结局（30 天病死率）和独立预测因素。
30 天病死率为 68.1%。EQUAL 假丝酵母菌评分中位数为 8。预测病死率的独立因素为感染性休克（危险比，1.84）、机械通气（危险比，2.03）和 EQUAL 假丝酵母菌评分（危险比，0.75）。
30 天病死率的预测因素为感染性休克、机械通气使用和 EQUAL 假丝酵母菌评分。建议对感染热带假丝酵母菌念珠菌血症的患者考虑 EQUAL 评分，以降低病死率。
