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Clinical characteristics, risk factors and outcomes of mixed Candida albicans/bacterial bloodstream infections.
- Source :
-
BMC infectious diseases [BMC Infect Dis] 2020 Nov 06; Vol. 20 (1), pp. 810. Date of Electronic Publication: 2020 Nov 06. - Publication Year :
- 2020
-
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.<br />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.<br />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.<br />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.
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2334
- Volume :
- 20
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 33158426
- Full Text :
- https://doi.org/10.1186/s12879-020-05536-z