title: Single-center retrospective study of the incidence of, and risk factors for, non-C. albicans invasive candidiasis in hospitalized patients in China.
abstract: The aims of this study were to establish the incidence of invasive candidiasis (IC) in a Beijing hospital, to identify risk factors associated with IC caused by non-C. albicans Candida (NAC), and to determine risk factors for infection caused by NAC species not susceptible to fluconazole. Clinical data from 141 patients admitted to Beijing Chaoyang Hospital (from 2001-2010) diagnosed with IC were retrospectively analyzed. The incidence of IC increased during the 10-year period, but the proportion due to NAC did not change significantly in that of 141 cases, 55 (39%) were due to NAC and 86 (61%) to C. albicans (CA). The NAC species isolated included C. tropicalis (25 of 141, 18%), C. glabrata (14 of 141, 9.9%), C. parapsilosis (eight of 141, 5.7%), C. krusei (three of 141, 2.1%) and C. lusitaniae (one of 141, 0.71%); other Candida species accounted for four of the 141 cases (2.8%). Twenty-one isolates (38%) of NAC were not susceptible to fluconazole. Total parenteral nutrition (TPN) (OR 4.2; 95% CI 3.5-58; P < 0.001) and previous fluconazole therapy (OR 7.7; 95% CI 2.2-27; P = 0.001) were risk factors for invasive NAC candidiasis, whereas patient age ≥65 years (OR 0.37; CI 0.16-0.88; P = 0.025) and invasive mechanical ventilation (OR 0.22; CI 0.069-0.70; P =0.010) were connected with invasive CA candidiasis. Prior fluconazole therapy was a risk factor (P = 0.007) for infections caused by NAC not susceptible to fluconazole. In conclusion, TPN and prior fluconazole therapy are independent risk factors for NAC infection, while prior fluconazole therapy is a risk factor for infection due to NAC not susceptible to fluconazole.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Wang
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Tong
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.forename: Lili
authors.initials: L
authors.lastname: Xu
authors.forename: Yanbing
authors.initials: Y
authors.lastname: Wu
authors.forename: Yingmei
authors.initials: Y
authors.lastname: Liu
authors.forename: Lin
authors.initials: L
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology; D002175:Candida / Q000145:classification* / Q000302:isolation & purification*; D058365:Candidiasis, Invasive / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D025141:Drug Resistance, Fungal; D005260:Female; D015725:Fluconazole / Q000494:pharmacology; D006761:Hospitals; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole
keywords: Candida albicans; incidence; invasive candidiasis; non-C. albicans Candida; risk factor