Emergency Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, China.
Center of Infectious Disease, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, China.
BMC Infect Dis. 2024 Nov 4;24(1):1234. doi: 10.1186/s12879-024-10128-2.
Candidemia leads to higher mortality and longer hospital-stay. While the studies about the clinical manifestations of candidemia caused by different Candida species and the relationship between the antifungal drugs and prognosis were rarely performed.
This retrospective study enrolled all 94 patients diagnosed as candidemia from January 2020 to July 2023 in BTCH. Demographic information, comorbidities, laboratory parameters, medications and prognosis were collected and analyzed.
C. albicans was the most common specie of candidemia. There was no significant difference in age, gender and hospital-mortality in different species groups. Higher-level and longer duration of broad-spectrum antibiotic use, lower BMI, hypoalbuminemia, longer duration of PN and history of G coccemia were conclusive about mortality. The C.tropicalis group had higher SCRE levels (F = 8.40, P = 0.03) and shorter TTP (F = 5.03, P < 0.01) than other species. No distinction was found in different antifungal drugs groups including triazoles and echinocandins after 7 days treatment (χ = 0.05, P = 0.81). The efficacy was no difference between triazoles and echinocandins in the different species groups. (χ = 1.20, P = 0.75; χ = 0.05, P = 0.81).
C. albicans accounts the most among candida induecd candidemia.The C.tropicalis group had higher SCRE levels and shorter TTP than other groups. Elder, hypoproteinemia, lower BMI, longer duration and higher-level of broad-spectrum antibiotic use, longer PN support and G coccemia increase risks for candidemia. The efficacy of triazoles and echinocandins are the same when blood culture turned negative in 7 days.
念珠菌血症可导致更高的死亡率和更长的住院时间。虽然有关于不同念珠菌引起的念珠菌血症的临床表现以及抗真菌药物与预后之间关系的研究很少进行。
本回顾性研究纳入了 2020 年 1 月至 2023 年 7 月在我院确诊为念珠菌血症的 94 例患者。收集并分析了人口统计学信息、合并症、实验室参数、药物和预后。
白色念珠菌是念珠菌血症最常见的菌种。不同菌种组在年龄、性别和院内死亡率方面无显著差异。广谱抗生素使用级别较高且时间较长、BMI 较低、低蛋白血症、PN 时间较长和 G 菌血症史与死亡率有关。C.tropicalis 组的 SCRE 水平较高（F=8.40，P=0.03），TTP 较短（F=5.03，P<0.01）。在不同的抗真菌药物治疗 7 天后，三唑类和棘白菌素类药物组之间没有区别（χ²=0.05，P=0.81）。不同菌种组中三唑类和棘白菌素类药物的疗效无差异（χ²=1.20，P=0.75；χ²=0.05，P=0.81）。
白色念珠菌是念珠菌血症的主要病原菌。C.tropicalis 组的 SCRE 水平和 TTP 均短于其他组。年龄较大、低蛋白血症、BMI 较低、广谱抗生素使用时间较长、级别较高、PN 时间较长和 G 菌血症可增加念珠菌血症的风险。在 7 天内血培养转为阴性时，三唑类和棘白菌素类药物的疗效相同。
