1. Clinical characteristics, risk factors and outcomes of mixed Candida albicans/bacterial bloodstream infections.
- Author
-
Zhong L, Zhang S, Tang K, Zhou F, Zheng C, Zhang K, Cai J, Zhou H, Wang Y, Tian B, Zhang Z, Cui W, Dong Z, and Zhang G
- Subjects
- Aged, Bacteremia microbiology, Bacteremia mortality, Candidiasis microbiology, Candidiasis mortality, China epidemiology, Cross Infection microbiology, Female, Humans, Kaplan-Meier Estimate, Klebsiella Infections microbiology, Klebsiella Infections mortality, Male, Middle Aged, Respiration, Artificial adverse effects, Retrospective Studies, Risk Factors, Staphylococcal Infections microbiology, Staphylococcal Infections mortality, Bacteremia complications, Candida albicans isolation & purification, Candidiasis complications, Klebsiella Infections complications, Klebsiella pneumoniae isolation & purification, Staphylococcal Infections complications, Staphylococcus aureus isolation & purification
- Abstract
Purpose: The purpose of this study was to explore the clinical features, risk factors, and outcomes of 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 hospitalized adults with Candida albicans bloodstream infection (CA-BSI) were recruited for this retrospective observational study from January 1, 2013, to December 31, 2018., Results: Of the 117 patients with CA-BSI, 24 patients (20.5%) had mixed-CA/B-BSIs. The most common copathogens were coagulase-negative Staphylococcus (CNS) (24.0%), followed by Klebsiella pneumoniae (20.0%) and Staphylococcus aureus (16.0%). In the multivariable analysis, a prior ICU stay > 2 days (adjusted odds ratio [OR], 7.445; 95% confidence interval [CI], 1.152-48.132) was an independent risk factor for mixed-CA/B-BSIs. Compared with patients with mono-CA-BSI, patients with mixed-CA/B-BSIs had a prolonged length of mechanical ventilation [17.5 (4.5, 34.8) vs. 3.0 (0.0, 24.5), p = 0.019] and prolonged length of ICU stay [22.0 (14.3, 42.2) vs. 8.0 (0.0, 31.5), p = 0.010]; however, mortality was not significantly different., Conclusions: There was a high rate of mixed-CA/B-BSIs cases among CA-BSI cases, and CNS was the predominant coexisting species. A prior ICU stay > 2 days was an independent risk factor for mixed -CA/B-BSIs. Although there was 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; this deserves further attention from clinicians.
- Published
- 2020
- Full Text
- View/download PDF