Clinical characteristics, risk factors, and outcomes of Candida albicans bloodstream and lower respiratory tract infections

Institute of Cardiovascular Diseases, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Medicine, Wuhan University of Science and Technology, Wuhan 430065, Hubei, China

^* Corresponding author: zhiyw111@163.com

Abstract

The purpose of this study was to investigate the clinical characteristics, risk factors and prognosis of patients with Candida albicans blood flow and lower respiratory tract infection Method: The data of 164 patients with suspected Candida albicans infection in a regional tertiary teaching hospital in China from January 2020 to December 2022 were analyzed retrospectively. We collected electronic recording data from patients with single Candida albicans bloodstream infection and patients with single Candida albicans lower respiratory tract infection. Mann-Whitney U test was used for retrospective study. Logistic regression analysis and comparison of prognostic risk factors between patients with single Candida albicans bloodstream infection and single Candida albicans lower respiratory tract infection. Results: among the 164 patients suspected of Candida albicans infection, 81 cases were diagnosed as single Candida albicans bloodstream infection (49.4%, 81/164). The average age of the patients was 57.4 years old, 51 cases (63.0%) were male, and the 30-day mortality was 18.5%. Multivariate regression analysis showed that hematologic malignancy [(OR),1.221; 95%(CI), 1.048~2.820, p=0.043)] was an independent predictor of 30-day mortality in patients with single Candida albicans bloodstream infection, length of stay [(OR), 0.924; 95% (CI), 0.868 ~ 0.983, p=0.012] and time of hormone use [(OR), 0.927]. 95% (CI), 0.870-0.988, p=0.019] were protective factors for patients with single Candida albicans bloodstream infection. There were 84 cases of lower respiratory tract infection caused by Candida albicans (51.2%, 84/164). The average age of the patients was 69.8 years old, and 70 cases (83.3%) were male. Three patients were randomly selected from 84 patients and 81 patients were analyzed. The 30-day mortality rate was 13.6%. Multivariate regression analysis showed that cerebrovascular accident [(OR), 1.072; 95%(CI),1.015~1.150, p=0.012] was an independent predictor of 30-day mortality in patients with Candida albicans lower respiratory tract infection. Conclusion: The proportion of lower respiratory tract infection in patients with Candida albicans infection is higher, and the basic diseases of patients with Candida albicans infection are mainly cerebrovascular accidents. There was no significant difference in mortality between patients with bloodstream infection and patients with lower respiratory tract infection, but patients with invasive operations such as CVC had a higher risk of bloodstream infection with single Candida albicans than patients with lower respiratory tract infection with single Candida albicans, which deserves further attention from clinicians. The analysis of this study shows that we should attach great importance to and guard against Candida infection in inpatients, and timely intervention treatment should be carried out when Candida infection is considered and Candida colonization is excluded. Correct identification of Candida albicans infection is particularly important to control infection and improve the condition. The monitoring of flora should be strengthened in key departments. Standardized intervention treatment after timely detection and diagnosis of Candida infection can effectively improve the prognosis of patients. The analysis of this study shows that we should attach great importance to and guard against Candida infection in inpatients, and timely intervention treatment should be carried out when Candida infection is considered and Candida colonization is excluded. Correct identification of Candida albicans infection is particularly important to control infection and improve the condition. The monitoring of flora should be strengthened in key departments. Standardized intervention treatment after timely detection and diagnosis of Candida infection can effectively improve the prognosis of patients.