title: Invasive candidiasis in intensive care units in China: Risk factors and prognoses of Candida albicans and non-albicans Candida infections.
abstract: To investigate the risk factors and prognoses of patients with invasive Candida albicans and non-albicans Candida (NAC) infection in intensive care units (ICUs) in China.
  
  
  
  Between November 2009 and April 2011, we performed a prospective study of critically ill patients with invasive Candida infection from 67 ICUs across China to compare the risk factors and mortality between patients with C albicans and NAC infection.
  
  
  
  There were 306 patients with proven invasive Candida; 244 cases (a total 389 Candida isolates) were sent to laboratory for strain identification (C albicans, 40.1%; NAC, 59.9%). More patients admitted for surgery or trauma had NAC infection than C albicans infection. C albicans infection was more common in patients with subclavian vein catheters or peritoneal drainage tubes. Compared with patients with C albicans infection, patients with NAC infection had longer antifungal therapy (P < .001), longer ICU (P = .004) or hospital stay (P = .002), and slightly higher mortality (38.4% vs 29.6%), but the difference was not significant (P = .17).
  
  
  
  C albicans remains the most common pathogen in candidiasis in critical care patients. However, the number of NAC infections exceeded C albicans infections. Compared with patients with C albicans infection, patients with NAC infection had heavier disease burdens.
authors.affiliation: Department of Intensive Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Gong
authors.affiliation: Department of Intensive Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Luan
authors.affiliation: Department of Intensive Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Xingmao
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Intensive Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Guofu
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Intensive Care Medicine, Nanjing Zhongda Hospital, Southeast University School of Medicine, Nanjing, China.
authors.forename: Haibo
authors.initials: H
authors.lastname: Qiu
authors.affiliation: Department of Intensive Care Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Kang
authors.affiliation: Department of Intensive Care Medicine, Henan Provincial People's Hospital, Zhengzhou, China.
authors.forename: Bingyu
authors.initials: B
authors.lastname: Qin
authors.affiliation: Department of Intensive Care Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Fang
authors.affiliation: Department of Intensive Care Medicine, The Second Affiliated Hospital, Zhejiang University School of Medcine, Hangzhou, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Cui
authors.affiliation: Department of Intensive Care Medicine, Tianjin Third Central Hospital, Tianjin, China.
authors.forename: Yingzhi
authors.initials: Y
authors.lastname: Qin
authors.affiliation: Department of Intensive Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
authors.forename: Jianguo
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Intensive Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China. Electronic address: zangbin66@aliyun.com.
authors.forename: Bin
authors.initials: B
authors.lastname: Zang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida / Q000145:classification* / Q000302:isolation & purification*; D058365:Candidiasis, Invasive / Q000453:epidemiology* / Q000401:mortality*; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D055815:Young Adult
keywords: Candida albicans; China; infection; intensive care unit; non-albicans; risk factor