Epidemiology and risk factors for nosocomial Non-<i>Candida albicans</i>candidemia in adult patients at a tertiary care hospital in North China

Ding, Xiurong; Yan, Donghui; Sun, Wei; Zeng, Zhili; Su, Rui-Rui; Su, Jianrong

doi:10.1093/mmy/myv060

Cited by 47 publications

(45 citation statements)

References 35 publications

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“…Several possible risk factors have been previously identified for the development of NAC candidaemia and include prior antifungal exposure, malignancy, immunosuppressive therapy, abdominal surgery [32], presence of CVCs [26], artificial surgical implants [17], head trauma and bacterial sepsis [29]. Our finding of an association of an indwelling urinary catheter and a higher risk of BSI caused by C. albicans vs. NAC is consistent with other studies [33].…”

Section: Discussionsupporting

confidence: 90%

“…associated with candidaemia varies greatly in different regions of the world. In recent years, some studies [8–10, 15–17] have observed a shift from the more antifungal susceptible type species C . albicans towards NAC spp., and this is corroborated by the findings of this 6-year study where NAC isolates accounted for the majority (64.4%) of all adult candidaemia episodes.…”

Section: Discussionmentioning

confidence: 99%

“…causing candidaemia, the proportion of non- albicans Candida (NAC) spp. is rising and has even exceeded that of C. albicans in some recent studies from Europe, Asia and America [8–10, 15–17]. …”

Section: Introductionmentioning

confidence: 99%

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Epidemiology, risk factors and outcomes of Candida albicans vs. non-albicans candidaemia in adult patients in Northeast China

Zhang

Song

et al. 2019

Epidemiol. Infect.

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This study aimed to evaluate the clinical characteristics, risk factors and outcomes of adult patients with candidaemia caused by C. albicans vs. non-albicans Candida spp. (NAC). All adult hospitalised cases of candidaemia (2012–2017) at a tertiary hospital in Shenyang were included in the retrospective study, and a total of 180 episodes were analysed. C. parapsilosis was the most frequently isolated species (38.3%), followed by C. albicans (35.6%), C. glabrata (13.9%), C. tropicalis (10%) and others (2.2%). As initial antifungal therapy, 75.0%, 3.9%, 5.6% and 2.2% of patients received fluconazole, caspofungin, micafungin and voriconazole, respectively. Multivariate analyses revealed that total parenteral nutrition was associated with an increased risk of NAC bloodstream infections (BSI) (OR 2.535, 95% CI (1.066–6.026)) vs. C. albicans BSI. Additionally, the presence of a urinary catheter was associated with an increased risk of C. albicans BSI (OR 2.295 (1.129–4.666)) vs. NAC BSI. Moreover, ICU stay (OR 4.013 (1.476–10.906)), renal failure (OR 3.24 (1.084–9.683)), thrombocytopaenia (OR 7.171 (2.152–23.892)) and C. albicans (OR 3.629 (1.352–9.743)) were independent risk factors for candidaemia-related 30-day mortality, while recent cancer surgery was associated with reduced mortality risk (OR 26.479 (2.550–274.918)). All these factors may provide useful information to select initial empirical antifungal agents.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Epidemiology, risk factors and outcomes of Candida albicans vs. non-albicans candidaemia in adult patients in Northeast China

Zhang

Song

et al. 2019

Epidemiol. Infect.

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“…Although several studies had reported the epidemiology of Candida infections in China, they mainly focused on adults, invasive Candida infections or conducted among special groups [14–17]. The investigation about Candida albicans ( C.albicans ) compared to non-C.albicans candidemia in neonatal groups are limited in China [18].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Candida albicans and non-C.albicans of neonatal candidemia at a tertiary care hospital in western China

Ding

et al. 2017

BMC Infect Dis

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BackgroundAlthough the majority of Candida infections occur in the developing world, candidemia epidemiology is poorly understood in these countries. The aim of this study was to investigate the epidemiology of non-Candida albicans (non-C. albicans) candidemia among neonates at Liuzhou Maternity and Child Healthcare Hospital in China.MethodsA retrospective review of all positive blood culture about Candida species in neonatal intensive care unit was conducted between January 2012 and November 2015. Information about demographics, risk factors and outcome of candidemia were collected. Univariate and multivariate logistic regression models were used to identify the risk factors associated with the development of non-C.albicans candidemia.ResultsThe prevalence of candidemia in infants was 1.4%. Non-C.albicans was responsible for 56.5% of neonatal candidemia. The predisposing factors for development of non-C.albicans candidemia among infants included mechanical ventilation [odds ratio (OR), 95% confidence interval (95%CI) = 3.13, 1.07–9.14; P = 0.037] and use of assisted reproductive technology (OR, 95%CI = 4.52, 1.39–14.77; P = 0.012). The overall mortality rate of candidemia was 8.7% and non-C.albicans attributed to 83.3% of all mortalities.Conclusions Non-C.albicans species are the major cause of candidemia in local neonatal group. The study highlights the urgent needs to evaluate the possibility of development of non-C.albicans candidemia in neonates exposed to these risk factors and much emphasis must be laid on the early implementation of medical intervention to reduce the incidences of candidemia in neonates.

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“…Worldwide, there is a paucity of data on detailed clinical and epidemiological features of PLABSI, such as predictive factors. Moreover, studies on the epidemiology of candidemia in Asian countries, especially in Japan, are limited [21–23]. …”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Blood Stream Infection due to Candida Species in a Tertiary Care Hospital in Japan over 12 Years: Importance of Peripheral Line-Associated Candidemia

et al. 2016

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BackgroundCandidemia is an important cause of mortality in healthcare settings. Peripheral lines are a source of candidemia, yet few studies have reported on the clinico-epidemiological features of candidemia due to peripheral-line associated blood stream infection (PLABSI).MethodsWe conducted a single-centre retrospective cohort study of all patients with candidemia between 2002 and 2013. PLABSI was defined as the presence of at least one of the following: the presence of phlebitis or the resolution of clinical symptoms after peripheral-line withdrawal, with careful exclusion of an alternative explanation for bacteraemia. We described the epidemiology of candidemia and assessed predictive factors of PLABSI due to Candida spp., peripheral line-associated candidemia (PLAC), compared with non-PLAC.ResultsA total of 301 episodes of candidemia, including 37 of PLAC, were diagnosed during the study period. Central-line associated blood stream infection, intra-abdominal infection, and infection of unknown source accounted for the remaining 233, 14, and 17 cases, respectively. The overall incidence rate of candidemia was 0.11/1000 patient-days. In multivariate analysis, cephalosporin exposure (odds ratio [OR] = 2.22, 95% CI 1.04–4.77), polymicrobial bacteraemia/fungaemia (OR = 2.87, 95% CI 1.02–8.10), and ID specialist consultation (OR = 2.40, 95% CI 1.13–5.13) were identified as independent predictors of PLAC. Although non-PLAC had a higher mortality, the length of hospital stay after candidemia was similar between the two groups and candidemia duration was longer in the PLAC group.ConclusionPLACs are an important cause of candidemia in hospitalized patients. Appropriate identification and management of PLAC are crucial.

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Epidemiology and risk factors for nosocomial Non-Candida albicanscandidemia in adult patients at a tertiary care hospital in North China

Cited by 47 publications

References 35 publications

Epidemiology, risk factors and outcomes of Candida albicans vs. non-albicans candidaemia in adult patients in Northeast China

Epidemiology, risk factors and outcomes of Candida albicans vs. non-albicans candidaemia in adult patients in Northeast China

Epidemiology of Candida albicans and non-C.albicans of neonatal candidemia at a tertiary care hospital in western China

Epidemiology of Blood Stream Infection due to Candida Species in a Tertiary Care Hospital in Japan over 12 Years: Importance of Peripheral Line-Associated Candidemia

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