[Candida species distribution in the patients with high risk of deep fungal infections and relevant risk factors: a prospective cohort study].
OBJECTIVE
To study the distribution of Candida spp. in the patients with high-risk of fungal infection and the risk factors of deep candidiasis.


METHODS
A prospective cohort study was performed among 440 consecutive hospitalized patients admitted to the hematology wards, geriatric wards, and ICUs from May 2004 to April 2005. Stool, urine, and saliva were cultured during the period 72 - 96 h after hospitalization for the first time and then once a week till the patient was discharged or by the end of the sixth week. If deep fungal infection was suspected culture of blood, sputum, bacterium-free body fluid, and/or biopsy specimens were cultured. Medical records were reviewed to analyze the possible risk factors.


RESULTS
426 strains of Candida spp. were isolated from 152 patients, with Candida albicans accounting for 67.4% and other Candida spp for 32.6%. 61 patients were discovered to express Candida colonization. The major species isolated from patients with Candida colonization was Candida albicans. The risk factors identified included two or more broad-spectrum antibiotic administration (odds ratio 16.204; 95% confidence interval, 2.005 to 130.980), Candida colonization (10.636; 3.743 to 30.222), and urinary canal administration (4.285; 1.399 to 13.127).


CONCLUSIONS
Candida albicans is still the major organism isolated from the high risk fungal infection patients. Two or more broad-spectrum antibiotic administration, Candida colonization, and urinary canal administration are proved to be the risk factors, with the broad-spectrum antibiotic administration exhibiting more influence than Candida colonization and urinary canal administration.
Yu
Jin
J
Research Center for Medical Mycology, Peking University First Hospital, Beijing, China.
Zhang
Min
M
Wang
Jian-Lei
JL
Xu
Wei-Lin
WL
Ou
Jin-Ping
JP
Wang
Feng-Rong
FR
Lai
Yue-Yun
YY
Liu
Fang
F
Ren
Han-Yun
HY
Huang
Xiao-Jun
XJ
Song
Yi-Xin
YX
An
You-Zhong
YZ
Li
Ruo-Yu
RY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002175:Candida / Q000187:drug effects / Q000302:isolation & purification; D002176:Candida albicans / Q000187:drug effects / Q000302:isolation & purification*; D002177:Candidiasis / Q000453:epidemiology / Q000382:microbiology*; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents