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Int J Infect Dis. 2014 May;22:4-8. doi: 10.1016/j.ijid.2013.11.011. Epub 2014 Feb 28.

Candidemia: incidence rates, type of species, and risk factors at a tertiary care academic hospital in China.

Author information

1
Emergency Department, Xinhua Hospital, Shanghai Jiaotong University Medical College, 1665 Kongjiang Road, Shanghai, China.
2
Department of Surgery, Xinhua Hospital, Shanghai Jiaotong University Medical College, Shanghai, China.
3
Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University Medical College, Shanghai, China.
4
Department of Clinical Microbiology, Xinhua Hospital, Shanghai Jiaotong University Medical College, Shanghai, China.
5
Department of Pediatrics, Xinhua Hospital, Shanghai Jiaotong University Medical College, Shanghai, China.
6
Emergency Department, Xinhua Hospital, Shanghai Jiaotong University Medical College, 1665 Kongjiang Road, Shanghai, China. Electronic address: panshuming73@yahoo.cn.

Abstract

OBJECTIVES:

To investigate the incidence rates of candidemia in hospitalized patients and to identify differences in risk factors of patients with Candida albicans and non-C. albicans and with Candida guilliermondii and non-C. guilliermondii candidemia.

METHODS:

Non-immunosuppressed, non-neutropenic inpatients with candidemia diagnosed after admission were included in this retrospective observational study at a tertiary academic hospital in China.

RESULTS:

During the study period (January 2009 to December 2011), 238 eligible patients had candidemia episodes with an incidence rate 5.4%. Of these patients, 29.8% had candidemia due to C. albicans, 27.7% due to C. parapsilosis, and 16.4% due to C. guilliermondii. Diabetes was a significant risk factor for patients with candidemia due to C. albicans (35.2%, 25/71) compared to candidemia due to non-C. albicans spp (13.2%, 22/167) (odds ratio (OR) 0.2792, 95% confidence interval (CI) 0.144-0.5412; p < 0.001). Compared to patients with candidemia due to non-C. guilliermondii spp, preterm birth with low birth weight (OR 0.0887, 95% CI 0.0398-0.1977; p < 0.001), intravenous nutrition (OR 0.0662, 95% CI 0.0226-0.1938), and surgery (OR 0.0662, 95% CI 0.0226-0.1938; p < 0.001) were significant risk factors for candidemia due to C. guilliermondii. Furthermore, compared to patients with candidemia due to C. albicans, patients with candidemia due to C. guilliermondii had markedly higher rates of central venous catheterization (85.9%, 61/71 vs. C. guilliermondii: 100%, 39/39; p = 0.013) and intravenous nutrition (89.7%, 35/39 vs. C. albicans: 42.2%, 30/71; p < 0.001).

CONCLUSIONS:

Candidemia due to C. albicans ranks first in incidence, and candidemia due to C. guilliermondii occurs in a significant proportion of our hospitalized patients.

KEYWORDS:

Candid albicans; Candida guilliermondii; Candidemia; Incidence

PMID:
24583564
DOI:
10.1016/j.ijid.2013.11.011
[Indexed for MEDLINE]
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