title: Candidemia: incidence rates, type of species, and risk factors at a tertiary care academic hospital in China.
abstract: OBJECTIVE
  To investigate the incidence rates of candidemia in hospitalized patients and to identify differences in risk factors of patients with Candida albicans and non-C. albicans and with Candida guilliermondii and non-C. guilliermondii candidemia.
  
  
  METHODS
  Non-immunosuppressed, non-neutropenic inpatients with candidemia diagnosed after admission were included in this retrospective observational study at a tertiary academic hospital in China.
  
  
  RESULTS
  During the study period (January 2009 to December 2011), 238 eligible patients had candidemia episodes with an incidence rate 5.4%. Of these patients, 29.8% had candidemia due to C. albicans, 27.7% due to C. parapsilosis, and 16.4% due to C. guilliermondii. Diabetes was a significant risk factor for patients with candidemia due to C. albicans (35.2%, 25/71) compared to candidemia due to non-C. albicans spp (13.2%, 22/167) (odds ratio (OR) 0.2792, 95% confidence interval (CI) 0.144-0.5412; p < 0.001). Compared to patients with candidemia due to non-C. guilliermondii spp, preterm birth with low birth weight (OR 0.0887, 95% CI 0.0398-0.1977; p < 0.001), intravenous nutrition (OR 0.0662, 95% CI 0.0226-0.1938), and surgery (OR 0.0662, 95% CI 0.0226-0.1938; p < 0.001) were significant risk factors for candidemia due to C. guilliermondii. Furthermore, compared to patients with candidemia due to C. albicans, patients with candidemia due to C. guilliermondii had markedly higher rates of central venous catheterization (85.9%, 61/71 vs. C. guilliermondii: 100%, 39/39; p = 0.013) and intravenous nutrition (89.7%, 35/39 vs. C. albicans: 42.2%, 30/71; p < 0.001).
  
  
  CONCLUSIONS
  Candidemia due to C. albicans ranks first in incidence, and candidemia due to C. guilliermondii occurs in a significant proportion of our hospitalized patients.
authors.affiliation: Emergency Department, Xinhua Hospital, Shanghai Jiaotong University Medical College, 1665 Kongjiang Road, Shanghai, China.
authors.forename: Zengbin
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Department of Surgery, Xinhua Hospital, Shanghai Jiaotong University Medical College, Shanghai, China.
authors.forename: Yingbin
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University Medical College, Shanghai, China.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Feng
authors.affiliation: Department of Clinical Microbiology, Xinhua Hospital, Shanghai Jiaotong University Medical College, Shanghai, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Emergency Department, Xinhua Hospital, Shanghai Jiaotong University Medical College, 1665 Kongjiang Road, Shanghai, China.
authors.forename: Shuyun
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Pediatrics, Xinhua Hospital, Shanghai Jiaotong University Medical College, Shanghai, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Emergency Department, Xinhua Hospital, Shanghai Jiaotong University Medical College, 1665 Kongjiang Road, Shanghai, China.
authors.forename: Qiqi
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Emergency Department, Xinhua Hospital, Shanghai Jiaotong University Medical College, 1665 Kongjiang Road, Shanghai, China. Electronic address: panshuming73@yahoo.cn.
authors.forename: Shuming
authors.initials: S
authors.lastname: Pan
mesh_terms: D002175:Candida / Q000502:physiology; D002176:Candida albicans / Q000502:physiology; D058387:Candidemia / Q000453:epidemiology*; D002177:Candidiasis / Q000453:epidemiology* / Q000382:microbiology; D002681:China / Q000453:epidemiology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010288:Parenteral Nutrition / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D063128:Tertiary Health Care
keywords: Candid albicans; Candida guilliermondii; Candidemia; Incidence