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Clinical characteristics and prognostic risk factors of candidemia in non-neutropenic patients: a retrospective cohort study

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Abstract

This study aimed to determine the clinical characteristics and the prognostic risk factors in non-neutropenic patients with candidemia. Data were retrospectively collected through the medical record information system. Non-neutropenic patients with candidemia were relatively aged, with a more than one-third rate of in-hospitalization mortality. In multivariate analysis, APACHE II score (adjusted odds ratio [aOR], 1.138; 95% confidence interval [CI], 1.067–1.213), septic shock (aOR, 5.704; 95% CI, 2.639–12.326) and RRT (aOR, 16.152; 95% CI, 2.628–99.275) (all P < 0.01) were independent related with non-survivors. In conclusion, non-neutropenic patients with candidemia have a high in-hospitalization mortality, and APACHE II, septic shock, and RRT are independently factors.

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Fig. 1
Fig. 2

Data availability

All data generated and/or analyzed during the current study are included in this manuscript.

Abbreviations

C. albicans :

Candida albicans

spp.:

species

NAC:

Non-albicans Candida

C. glabrata :

Candida glabrata

C. parapsilosis :

Candida parapsilosis

C. tropicalis :

Candida tropicalis

IQR:

Interquartile range

APACHE:

High acute physiology and chronic health evaluation

ICU:

Intensive care unit

TPN:

Total parenteral nutrition

CVC:

Central venous catheter

RRT:

Renal replacement therapy

IQR:

Interquartile range

MV:

Mechanical ventilation

OR:

Odds ratio

CI:

Confidence interval

BSI:

Bloodstream infection

CNS :

Coagulase-negative Staphylococcus

K. pneumoniae :

Klebsiella pneumoniae

A. baumannii :

Acinetobacter baumannii

S. aureus :

Staphylococcus aureus

E. faecium :

Enterococcus faecium

E. faecalis :

Enterococcus faecalis

E. cloacae :

Enterococcus cloacae

P. aeruginosa :

Pseudomonas aeruginosa

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Funding

This work was supported in part by grants from Medical and Health Research Program of Zhejiang Province (No. 2021KY174, GS Zhang; No. 2022498722, K Zhang; No. 2021KY1094, FQ Liu).

Author information

Author notes

  1. Fengqi Liu, Xueping Shao and Zhaohui Dong contributed equally to this work.

Authors and Affiliations

  1. Department of Critical Care Medicine, the First People’s Hospital of Huzhou, First Affiliated Hospital of Huzhou University, Huzhou, 313000, Zhejiang, China

    Fengqi Liu, Xueping Shao, Zhaohui Dong, Kankai Tang, Li Zhong, Wei Xu & Zhidong Chen

  2. Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China

    Fengqi Liu, Kai Zhang, Wei Cui & Gensheng Zhang

  3. Department of Critical Care Medicine, Taizhou Municipal Hospital, Taizhou, 318000, Zhejiang, China

    Cheng Zheng

  4. Clinical Microbiology Laboratory, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China

    Jiachang Cai & Hongwei Zhou

  5. Department of Gastroenterology, Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China

    Chuangao Xie

  6. Department of General Surgery, Huzhou Third Municipal Hospital, Affiliated With Huzhou University, Huzhou, 313000, Zhejiang, China

    Liangfeng Zhang

  7. Zhejiang Province Clinical Research Center for Emergency and Critical Care Medicine, 88 Jiefang Road, Hangzhou, 310009, China

    Gensheng Zhang

  8. Ministry of Education, Key Laboratory of Multiple Organ Failure (Zhejiang University), Hangzhou, 310009, China

    Gensheng Zhang

Authors
  1. Fengqi Liu
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  2. Xueping Shao
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  9. Kai Zhang
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  11. Hongwei Zhou
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  12. Wei Cui
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  13. Chuangao Xie
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  14. Liangfeng Zhang
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  15. Gensheng Zhang
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Contributions

Gensheng Zhang designed the study, revised the manuscript, and gave final approval of the version to be published; Fengqi Liu, Xueping Shao and Zhaohui Dong prepared for the draft of the manuscript and collected/analyzed the data. Kankai Tang, Li Zhong, Wei Xu, Zhidong Chen, Cheng Zheng, Kai Zhang, Jiachang Cai, Hongwei Zhou, Wei Cui, Chuangao Xie and Liangfeng Zhang collected and analyzed the data. All authors read and approved the final manuscript. Fengqi Liu, Xueping Shao and Zhaohui Dong contributed equally to this work.

Corresponding authors

Correspondence to Chuangao Xie, Liangfeng Zhang or Gensheng Zhang.

Ethics declarations

Ethics approval and informed consent

This study received human research ethics approval (NO. 2020–744) from the Ethics Committee of the Second Affiliated Hospital, Zhejiang University School of Medicine. We ensure the confidentiality of patient data and comply with the Helsinki statement. Due to the retrospective nature of the study, the Ethics Committee determined that no patient consent was required.

Competing interests

The authors have no relevant financial or non-financial interests to disclose.

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Liu, F., Shao, X., Dong, Z. et al. Clinical characteristics and prognostic risk factors of candidemia in non-neutropenic patients: a retrospective cohort study. Eur J Clin Microbiol Infect Dis 42, 1389–1394 (2023). https://doi.org/10.1007/s10096-023-04672-z

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  • DOI: https://doi.org/10.1007/s10096-023-04672-z

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