Bilal Hazrat, Li Xiaohui, Wang Xunsong, Khan Muhammad Nadeem, Shafiq Muhammad, Yu Jiamei, Qiu Hanman, Lv Qiao-Li, Xu Bin
Jiangxi Key Laboratory of Oncology (2024SSY06041), JXHC Key Laboratory of Tumor Metastasis, NHC Key Laboratory of Personalized Diagnosis and Treatment of Nasopharyngeal Carcinoma, Jiangxi Cancer Hospital & Institute, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China.
Department of Medical Laboratory, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Cancer Institute, Nanchang, Jiangxi, China.
Front Microbiol. 2025 Jul 22;16:1630226. doi: 10.3389/fmicb.2025.1630226. eCollection 2025.
Candidiasis in cancer patients remains largely unexplored in China. This study examines risk factors and antifungal susceptibility patterns of in cancer patients from Jiangxi, China.
Clinical and demographic data on in cancer patients (2018-2024) were retrospectively collected at Jiangxi Cancer Hospital, Nanchang, China. distribution across cancers and antifungal susceptibility patterns were analyzed. Risk factors were identified via logistic regression, and antifungal consumption was correlated with distribution. Survival probabilities were compared between patients with and those with non- (NAC) infections.
Among 2,761 isolates, 1,703 (61.68%) were and 1,058 (38.31%) were NAC, with a year-wise trend showing a decline in and a rise in NAC. was significantly higher in lung (40.57%) and nasopharyngeal (11.33%) cancers, while NAC were more common in gastric (7.56%), colon (8.69%), and urogenital (14.65%) cancers. NAC risk factors included inappropriate empirical therapy (OR 13.8, < 0.001), hypoproteinemia (OR 1.35), anemia (OR 1.28), urinary tract infection (OR 1.71), and indwelling catheters (OR 1.27) (all < 0.05). Radiotherapy, targeted therapy, glucocorticoids, chest tube insertion, and parenteral nutrition were associated with ( ≤ 0.01). Amphotericin B (>99%) and echinocandins (>96%) showed the highest efficacy. displayed notable azole resistance (40.9-74.45%). Caspofungin use negatively correlated with ( = -0.84, = 0.02) and positively with ( = 0.78, = 0.04) and ( = 0.85, = 0.02). NAC infections showed 1.5-fold higher mortality rate than (95% CI: 1.1-2.0; = 0.0075).
These findings may aid healthcare officials in improving management in the region and similar settings.
中国癌症患者的念珠菌病在很大程度上仍未得到充分研究。本研究调查了中国江西癌症患者念珠菌感染的危险因素及抗真菌药敏模式。
回顾性收集了中国南昌江西癌症医院2018 - 2024年癌症患者的临床和人口统计学数据。分析了念珠菌在各类癌症中的分布情况及抗真菌药敏模式。通过逻辑回归确定危险因素，并将抗真菌药物的使用与念珠菌分布进行关联分析。比较了念珠菌感染患者与非念珠菌感染患者（NAC）的生存概率。
在2761株念珠菌分离株中，1703株（61.68%）为念珠菌感染，1058株（38.31%）为非念珠菌感染，逐年趋势显示念珠菌感染呈下降，非念珠菌感染呈上升。念珠菌在肺癌（40.57%）和鼻咽癌（11.33%）中显著更高，而非念珠菌感染在胃癌（7.56%）、结肠癌（8.69%）和泌尿生殖系统癌症（14.65%）中更常见。非念珠菌感染的危险因素包括经验性治疗不当（OR 13.8，P < 0.001）、低蛋白血症（OR 1.35）、贫血（OR 1.28）、尿路感染（OR 1.71）和留置导管（OR 1.27）（均P < 0.05）。放疗、靶向治疗、糖皮质激素、胸腔置管和肠外营养与念珠菌感染相关（P ≤ 0.01）。两性霉素B（>99%）和棘白菌素类（>96%）显示出最高的疗效。念珠菌对唑类药物表现出显著耐药（40.9 - 74.45%）。卡泊芬净的使用与念珠菌感染呈负相关（r = -0.84，P = 0.02），与光滑念珠菌和热带念珠菌呈正相关（r分别为0.78，P = 0.04和r = 0.85，P = 0.02）。非念珠菌感染的死亡率比念珠菌感染高1.5倍（95%CI：1.1 - 2.0；P = 0.0075）。
这些发现可能有助于卫生保健官员改善该地区及类似环境中的念珠菌感染管理。
