Clinical characteristics and risk factors of mortality in patients with candidemia: a four-year retrospective study

念珠菌血症患者的临床特征和死亡风险因素:一项为期四年的回顾性研究

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Abstract

PURPOSE: Although candidemia has been reported globally, little is known about the differences in candidemia episodes between ICU and regular wards or the correlation between serum biomarkers and mortality from candidemia in medium and small cities. PATIENTS AND METHODS: We conducted a retrospective study of the risk factors and clinical outcomes of hospitalized patients with candidemia from 2021 to 2024 in southwest China. A multivariate logistic regression model was performed to investigate several potential risk factors for mortality. RESULTS: We collected 152 non-duplicate candidemia isolates during the study period. Candida albicans was the leading species causing candidemia (33.6%), and 96.7% of these isolates were susceptible to amphotericin B. Compared with regular patients, patients admitted to ICU were more frequently subjected to severe clinical presentations, extensive invasive procedures, and heavy exposure to antibiotics. In addition, the mortality in ICU was significantly higher than that in regular wards. Multivariable analysis revealed that 30-day readmission, mechanical ventilation, and ICU admission were independent factors associated with 30-day mortality. Moreover, we observed that high levels of PCT, BDG, and IL-6, as well as low PLT counts were also associated with mortality from candidemia. CONCLUSIONS: A better understanding of the specific risk factors across ICU wards could facilitate the identification of high-risk candidates for early antifungal therapy, thereby improving the outcomes for critically ill patients with candidemia.

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