Epidemiology and Clinical Features of <i>Candida</i> Bloodstream Infections: A 10-Year Retrospective Study in a Korean Teaching Hospital
Shi Nae Yu | Sun In Hong | Jung Wan Park | Min Hyok Jeon | Oh Hyun Cho
<i>Candida</i> species are major pathogens of bloodstream infections (BSIs) in hospitalized patients, with high mortality. This study examined <i>Candida</i> species distribution, clinical characteristics, and the mortality of patients with <i>Candida</i> BSIs. Adult patients (≥16 years) with <i>Candida</i> BSIs at a teaching hospital (2014–2023) were retrospectively reviewed. Over 10 years, 487 <i>Candida</i> isolates were obtained from 462 patients. <i>C. albicans</i> was the most frequent (38.2%), followed by <i>C. glabrata</i> (21.1%), <i>C. parapsilosis</i> (20.5%), and <i>C. tropicalis</i> (13.3%). The annual incidence of <i>Candida</i> BSIs remained stable (<i>p</i> = 0.525). However, non-<i>albicans</i> species BSIs increased 1.61-fold compared to <i>C. albicans</i> (95% CI: 1.19–2.19, <i>p</i> = 0.002). Fluconazole-non-susceptible <i>Candida</i> isolates increased after 2021 (<i>p</i> = 0.040). The overall 30-day mortality was 40.6%. In the multivariate analysis, a high Charlson comorbidity index (aHR: 1.20, 95% CI: 1.07–1.35, <i>p</i> = 0.001) and high SOFA score (aHR: 1.12, 95% CI: 1.02–1.23, <i>p</i> = 0.022) were the strongest predictors of 30-day mortality. Meanwhile, <i>C. parapsilosis</i> BSIs (aHR: 0.46, 95% CI: 0.22–0.99, <i>p</i> = 0.047) and central venous catheter removal at any time (aHR: 0.22, 95% CI: 0.13–0.37, <i>p</i> < 0.001) were associated with reduced 30-day mortality. The mortality of patients with <i>Candida</i> BSIs was mainly determined by disease severity, while catheter removal was associated with improved survival.
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