Clinical characteristics, risk factors and outcomes of mixed Candida albicans/bacterial bloodstream infections

Abstract

Purpose: The purpose of this study was to explore the clinical features, risk factors, and outcomes of the mixed Candida albicans/bacterial bloodstream infections (mixed-CA/B-BSIs) compared with monomicrobial Candida albicans bloodstream infection (mono-CA-BSI) in adult patients in China.Methods: All adult hospitalized cases ofadults with Candida albicans bloodstream infection (CA-BSI) were recruited in thefor this retrospective observational study from January 1, 2013, to December 31, 2018.Results: Of the 117 patients with CA-BSI, 24 patients (20.5%) werehad mixed-CA/B-BSIs. The most common co-pathogenscopathogens were Coagulasecoagulase-negative Staphylococcus (CNS) (24.0%), followed by Klebsiella pneumoniae (20.0%) and Staphylococcus aureus (16.0%). In the multivariable analysis, a prior ICU stay>2days >2 days (adjusted odds ratio [OR], 7.808445; 95% confidence interval [CI], 1.264152-48.233132) was an independent risk factor offor mixed-CA/B-BSIs. In comparisonCompared with patients with mono-CA-BSI, patients with mixed-CA/B-BSIs developed withhad a prolonged length of mechanical ventilation [17.5 (4.5, 34.8) vs. 3.0 (0.0, 24.5), Pp=0.019],] and prolonged length of ICU stay [22.0 (14.3, 42.2) vs. 8.0 (0.0, 31.5), Pp=0.010], whereas the ]; however, mortality was not significantly different. Conclusions: AThere was a high rate of mixed-CA/B-BSIs iscases among CA-BSI cases, and Coagulase-negative Staphylococcus isCNS was the predominant co-existedcoexisting species. PriorA prior ICU stay >2 days iswas an independent risk factor for mixed -CA/B-BSIs. Although there iswas no difference in mortality, the outcomes of patients with mixed -CA/B-BSIs, including prolonged length of mechanical ventilation and prolonged length of ICU stay, were worse than those with mono-CA-BSI, which; this deserves further attention offrom clinicians.