title: [Candidemia combined with bacterial bloodstream infection: analysis of clinical features and associated risk factors].
abstract: OBJECTIVE
  To investigate the clinical characteristics of and risk factors for candidemia combined with bacterial bloodstream infection(BSI) by retrospective analysis of cases.
  
  
  METHODS
  The clinical data of cases diagnosed as candidemia combined with BSI confirmed by blood culture were compared with those of cases with mono-candidemia in Beiing Tongren Hospital from January 2009 to December 2011. A logistic regression analysis was performed to investigate the independent risk factors.
  
  
  RESULTS
  Forty-two cases diagnosed as candidemia were analyzed including 14 cases of candidemia combined with BSI and 28 cases of mono-candidemia. Ten strains of gram-positive cocci and 4 strains of gram-negative bacilli were isolated from candidemia combined with BSI group.Six strains of C.albicans, 4 strains of C.glabrata, 3 strains of C.tropicalis and 1 strain of C.krosei were isolated. There was no C.parapsilosis isolated from candidemia combined with BSI group but 9 strains in the mono-candidemia group. The septic shock rate of the candidemia combined with BSI group was higher than that of the mono-candidemia group (12/14 vs 7/28, P = 0.000). The mortality rate of the candidemia combined with BSI group was higher than that of the mono-candidemia group (10/14 vs 15/28), but the difference did not reach statistical significance (P = 0.266).Four factors were found statistically different by univariate analysis, including hospitalization more than 4 weeks (P = 0.001), bacteremia before candidemia(P = 0.005), hematological tumor (P = 0.01) and abdominal infection (P = 0.001). Multivariate analysis showed that hospitalization more than 4 weeks was the independent risk factor.
  
  
  CONCLUSIONS
  Gram-positive cocci were the predominant species and septic shock was more common in candidemia combined with BSI. Hospitalization more than 4 weeks was the independent risk factor for candidemia combined with BSI.
authors.affiliation: Department of Respiratory Medicine,Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Respiratory Medicine,Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China. Email: suny@ccmu.edu.cn.
authors.forename: Yongchang
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Respiratory Medicine,Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhuo
authors.affiliation: Department of Respiratory Medicine,Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
authors.forename: Xiaofang
authors.initials: X
authors.lastname: Liu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D002175:Candida / Q000145:classification / Q000302:isolation & purification*; D058387:Candidemia / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012772:Shock, Septic / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology
chemical_list: D000935:Antifungal Agents