Xiaoying Gong1, Ting Luan1, Xingmao Wu1, Guofu Li1, Haibo Qiu2, Yan Kang3, Bingyu Qin4, Qiang Fang5, Wei Cui6, Yingzhi Qin7, Jianguo Li8, Bin Zang9. 1. Department of Intensive Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China. 2. Department of Intensive Care Medicine, Nanjing Zhongda Hospital, Southeast University School of Medicine, Nanjing, China. 3. Department of Intensive Care Medicine, West China Hospital, Sichuan University, Chengdu, China. 4. Department of Intensive Care Medicine, Henan Provincial People's Hospital, Zhengzhou, China. 5. Department of Intensive Care Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, China. 6. Department of Intensive Care Medicine, The Second Affiliated Hospital, Zhejiang University School of Medcine, Hangzhou, China. 7. Department of Intensive Care Medicine, Tianjin Third Central Hospital, Tianjin, China. 8. Department of Intensive Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China. 9. Department of Intensive Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China. Electronic address: zangbin66@aliyun.com.
Abstract
BACKGROUND: To investigate the risk factors and prognoses of patients with invasive Candida albicans and non-albicans Candida (NAC) infection in intensive care units (ICUs) in China. METHODS: Between November 2009 and April 2011, we performed a prospective study of critically ill patients with invasive Candida infection from 67 ICUs across China to compare the risk factors and mortality between patients with C albicans and NAC infection. RESULTS: There were 306 patients with proven invasive Candida; 244 cases (a total 389 Candida isolates) were sent to laboratory for strain identification (C albicans, 40.1%; NAC, 59.9%). More patients admitted for surgery or trauma had NAC infection than C albicans infection. C albicans infection was more common in patients with subclavian vein catheters or peritoneal drainage tubes. Compared with patients with C albicans infection, patients with NAC infection had longer antifungal therapy (P < .001), longer ICU (P = .004) or hospital stay (P = .002), and slightly higher mortality (38.4% vs 29.6%), but the difference was not significant (P = .17). CONCLUSIONS: C albicans remains the most common pathogen in candidiasis in critical care patients. However, the number of NAC infections exceeded C albicans infections. Compared with patients with C albicans infection, patients with NAC infection had heavier disease burdens.
BACKGROUND: To investigate the risk factors and prognoses of patients with invasive Candida albicans and non-albicans Candida (NAC) infection in intensive care units (ICUs) in China. METHODS: Between November 2009 and April 2011, we performed a prospective study of critically illpatients with invasive Candida infection from 67 ICUs across China to compare the risk factors and mortality between patients with C albicans and NAC infection. RESULTS: There were 306 patients with proven invasive Candida; 244 cases (a total 389 Candida isolates) were sent to laboratory for strain identification (C albicans, 40.1%; NAC, 59.9%). More patients admitted for surgery or trauma had NACinfection than C albicans infection. C albicans infection was more common in patients with subclavian vein catheters or peritoneal drainage tubes. Compared with patients with C albicans infection, patients with NAC infection had longer antifungal therapy (P < .001), longer ICU (P = .004) or hospital stay (P = .002), and slightly higher mortality (38.4% vs 29.6%), but the difference was not significant (P = .17). CONCLUSIONS: C albicans remains the most common pathogen in candidiasis in critical care patients. However, the number of NAC infections exceeded C albicans infections. Compared with patients with C albicans infection, patients with NAC infection had heavier disease burdens.
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