Systematic Characterization of Epidemiology, Antifungal Susceptibility, Risk Factors and Outcomes of Candidaemia: A Six-Year Chinese Study.

BACKGROUND

bloodstream infection (BSI), the fourth most common nosocomial BSI, is an urgent global health challenge with the tremendous growth in antifungal resistance rate and mortality rate.

PURPOSE

To establish the epidemiology, species distribution, risk factors, and 30-day mortality of candidaemia among 115 patients in this 6-year surveillance study.

MATERIALS AND METHODS

We retrospectively analyzed the clinical characteristics, epidemiology, antifungal susceptibility patterns, and risk factors for morbidity and mortality of 115 candidaemia cases diagnosed in one tertiary care hospital from January 2016 through December 2021.

RESULTS

Of the 115 candidaemia cases, the most prevalent species were (33.0%), followed by (27.8%), complex (19.1%), and others. The overall incidence was 0.21 cases/1000 admissions. The overall crude resistance rate of spp. against azoles was 20.0% (23/115), while showed a significant increase in the resistance rate to azoles (from 1/6, 16.7% in 2017 to 6/10, 60.0% in 2021). Multivariate analyses demonstrated that hematological malignancy and neutropenia were significantly associated with BSI than non- BSI. BSI had a significantly higher rate of previous surgery than non- BSI. BSI had a significantly higher rate of receiving total parenteral nutrition (TPN). The overall 30-day mortality rate was 27.0% (31/115). The presence of high age-adjusted Charlson comorbidity index (aCCI), neutropenia, and septic shock were factors independently associated with increased 30-day mortality.

CONCLUSION

are emerging as the predominant isolate in candidaemia. Of note, the unexpectedly increased resistance rate to azoles in BSI was observed. The aCCI scores, neutropenia, and septic shock were independently associated with 30-day mortality. Prompt, adequate antifungal treatment among high-risk patients may lead to a reduction in mortality.