Comparative Analysis of Epidemiological and Clinical Characteristics Between Invasive Infection versus Colonization in Critically Ill Patients in a Tertiary Hospital in Anhui, China.

OBJECTIVE

Invasive infections due to spp. have unique epidemiology, strain distribution, antimicrobial susceptibility, and clinical features. This study aimed to compare and evaluate these characteristic variables between invasive infection and colonization of critically ill patients in local China to potentially improve differential diagnosis and therapy.

METHODS

A total of 193 critically ill patients were recruited and followed up for the study, and 133 isolates were obtained from invasive -infected or -colonized subjects. The strains were identified to species level through matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry, assisted by DNA sequencing. susceptibility to common antifungals, including azoles, was determined by microbroth ATB Fungus 3 methodology. Azole resistance-related gene sequencing and homologous 3D-structure modeling were employed. Patient demographics and clinical risk factors were documented and comparatively analyzed from the hospital information-management system.

RESULTS

Non- (56%) principally caused invasive infections, while (55.17%) contributed more to colonization in critically ill patients. Additional risk factors exerted significant impact on both cohorts, primarily including invasive interventions, cancers, and concurrent infections in common. Most colonized spp. harbored relatively higher sensitivity to azoles. gene mutations of T348A and A1309G, A395T and C461T, and a novel G1193T to our knowledge were identified in azole-resistant , , and respectively, and their corresponding homologous 3D-structure modeling was putatively achieved.

CONCLUSION

Distinct epidemiological and clinical characteristics existed between invasive infection and colonization in critically ill patients. Multiple risk factors significantly involved both the cohorts. Colonized exhibited generally higher azole sensitivity than invasively infectious counterparts. point mutations had mechanistically potential ties with local resistance to azoles.