Clinical features and prognostic risk factors of candidemia in non-intensive care unit wards
10.3760/cma.j.issn.1674-2397.2015.02.006
- VernacularTitle:非重症监护病房假丝酵母菌血症的临床和预后危险因素分析
- Author:
Ming ZHANG
;
Hua ZHOU
;
Jianying ZHOU
- Publication Type:Journal Article
- Keywords:
Fungemia;
Clinical features;
Prognosis;
Risk factors
- From:
Chinese Journal of Clinical Infectious Diseases
2015;8(2):123-127
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate clinical features,pathogen distribution and prognostic risk factors of candidemia in patients from non-intensive care unit (ICU) wards.Methods Seventy two patients with blood culture-confirmed candidemia were admitted in non-ICU wards in the First Affiliated Hospital of Zhejiang University during January 1 st 2011 and January 31 th 2014.The clinical data of patients,including clinical features,pathogen distribution,treatment and prognosis were retrospectively analyzed.The risk factors for the infection and the fatality of patients were assessed by chi-square test,Fisher exact probability test and multivariate Logistic regression analysis.Results Among 72 patients with candidemia,29 (40.28％) were related to Candida albicans and 43 (59.72％) were related to non-Candida albicans.Univariate analysis showed that elderly people (x2 =6.109,P ＜ 0.05),male (x2 =5.258,P ＜ 0.05),solid tumor (x2 =7.186,P ＜ 0.01),parenteral nutrition (x2 =6.512,P ＜ 0.05),surgery within 30 d (x2 =4.284,P ＜ 0.05),indwelling gastric tube (x2 =4.164,P ＜ 0.05),and indwelling urethral catheter (x2 =3.952,P ＜ 0.05) were risk factors of Candida albicans-related candidemia;while patients with hematologic malignancies (P ＜ 0.0l) and neutropenia (P ＜ 0.05) were prone to non-Candida albicansrelated candidemia.Fourteen cases died within 28 days from the diagnosis of candidemia with an overall 28-d fatality rate of 19.44％.Multivariate Logistic regression analysis indicated that septic shock(OR:84.818,95％ confidential interval:3.560-2020.567,P ＜ 0.01)and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score (OR:1.252,95％ confidential interval:1.035-1.515,P ＜ 0.05) were independent risk factors of death,while removal or replacement of central venous catheter (OR:0.002,95 ％ confidential interval:0-0.135,P ＜ 0.01) was a protective factor.Conclusions There are more non-Candida albicans-related candidemia than Candida albicans-related candidemia in non-ICU wards.Patients with high APACHE Ⅱ score and septic shock usually have poor prognosis,while removal or replacement of central venous catheter may improve the prognosis.
