Positive sputum culture of spp as a risk factor for 30-day mortality in patients with hospital-acquired pneumonia: A propensity-score matched retrospective clinical study.

BACKGROUND

Candida species ( spp) are commonly isolated microorganisms from lower respiratory tract (LRT) specimens of patients with hospital-acquired pneumonia (HAP); however, the clinical significance remains controversial. This study aimed to investigate the correlation between spp. in the LRT and the clinical features and prognosis of HAP.

METHODS

This retrospective analysis included eligible patients with HAP from the database of a prospective study carried out between 2018 and 2019 in nine Chinese hospitals. Data on demographics, clinical characteristics, and prognosis were collected and analyzed. Propensity score matching (PSM) was used to balance the baseline characteristics.

RESULTS

A total of 187 HAP patients were enrolled. After PSM of severity score, 27 cases with positive sputum culture of spp were compared with the control group at a ratio of 1:1. The -positive group had more bacterial isolates in blood culture than the -negative group (39.1% [9/23] . 7.7% [2/26],  = 6.928, effect size [ES] = 0.38, 95% CI: 0.12-0.61,  = 0.008). The proportion of patients with chronic lung diseases was significantly higher in the -positive group (55.6% [15/27] . 22.2% [6/27],  = 6.312, ES = 0.34, 95% CI: 0.07-0.59,  = 0.012). The 30-day prognosis of HAP was significantly different between the two groups (80.8% [21/26] . 38.5% [10/26],  = 9.665, ES = 0.43, 95% CI: 0.19-0.66,  = 0.002). Univariable logistic regression analysis showed that LRT spp colonization was a risk factor for 30-day mortality of HAP (OR = 6.720, 95% CI: 1.915-23.577, 0.003).

CONCLUSIONS

spp in the LRT was associated with 30-day mortality of HAP. Patients with chronic underlying lung diseases tend to have spp colonization.