Clinical characteristics and outcomes of patients with candidemia during the COVID-19 pandemic: Insights from experience in the Omicron era

IF 4.5 2区 医学 Q2 IMMUNOLOGY Journal of Microbiology Immunology and Infection Pub Date : 2024-08-03 DOI:10.1016/j.jmii.2024.07.014
Geng-Lou Lin , Po-Hsun Chang , Ing-Kit Lee , Yi-Chun Chen , Chen-Hsiang Lee
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Abstract

Background

In Taiwan, COVID-19 outbreaks caused by the Omicron variant occurred in 2022. We investigated the incidence of candidemia during COVID-19 pandemic and the mortality of candidemia patients with COVID-19 in Taiwan.

Methods

The incidence of candidemia and fluconazole susceptibility of Candida species before (2015–2019) and during COVID-19 pandemic (2020–2023) at Kaohsiung Chang Gung Memorial Hospital were investigated. The associated factors with mortality in candidemia patients during COVID-19 pandemic were analyzed. Candidemia patients who had COVID-19 within the prior 90 days (case group, n = 34) were propensity-score matched for age, ICU admission, and abdominal surgery in a 1:4 ratio with candidemia patients without COVID-19 (control group, n = 136).

Results

Age (adjusted odds ratio [AOR] = 1.02, 95% CI: 1.01–1.03), ICU stay (AOR = 1.84, 95% CI: 1.29–2.62), higher Charlson comorbidity index (AOR = 1.08, 95% CI: 1.03–1.13), corticosteroid use (AOR = 1.50, 95% CI: 1.04–2.17) were associated with increased risk of mortality; abdominal surgery (AOR = 0.47, 95% CI: 0.29–0.74) and infected by Candida parapsilosis (AOR = 0.61, 95% CI: 0.38–0.98) were associated with decreased risk of mortality. After matching, there was no significant difference in mortality rates between the case and control groups. The incidence of candidemia increased from 196 to 278 patients/100,000 admissions during COVID-19 pandemic, while the causative species of candidemia and fluconazole susceptibility rates were similar.

Conclusion

While the incidence of candidemia increased during COVID-19 pandemic, there was no significant difference in mortality between candidemia patients with and without COVID-19 in the Omicron era.

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COVID-19 大流行期间念珠菌血症患者的临床特征和预后:从 Omicron 时代的经验中获得的启示。
背景:台湾在2022年爆发了由Omicron变种引起的COVID-19。我们调查了台湾 COVID-19 大流行期间念珠菌血症的发病率以及 COVID-19 念珠菌血症患者的死亡率:方法:调查了高雄长庚纪念医院在 COVID-19 大流行之前(2015-2019 年)和期间(2020-2023 年)念珠菌血症的发病率以及念珠菌对氟康唑的敏感性。分析了COVID-19大流行期间念珠菌病患死亡率的相关因素。将在 90 天内感染过 COVID-19 的念珠菌病患者(病例组,n = 34)与未感染过 COVID-19 的念珠菌病患者(对照组,n = 136)按 1:4 的比例在年龄、入住 ICU 和腹部手术方面进行倾向得分匹配:结果:年龄(调整赔率[AOR] = 1.02,95% CI:1.01-1.03)、入住 ICU(AOR = 1.84,95% CI:1.29-2.62)、较高的 Charlson 合并症指数(AOR = 1.08,95% CI:1.03-1.13)、使用皮质类固醇(AOR = 1.50,95% CI:1.04-2.17)与念珠菌病风险增加相关。腹部手术(AOR = 0.47,95% CI:0.29-0.74)和副丝状念珠菌感染(AOR = 0.61,95% CI:0.38-0.98)与死亡风险增加有关。匹配后,病例组和对照组的死亡率无明显差异。在COVID-19大流行期间,念珠菌血症的发病率从196例/10万住院患者上升到278例/10万住院患者,而念珠菌血症的致病菌种类和氟康唑敏感率却相似:结论:虽然在 COVID-19 大流行期间,念珠菌血症的发病率有所上升,但在 Omicron 时代,感染 COVID-19 和未感染 COVID-19 的念珠菌血症患者的死亡率并无明显差异。
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来源期刊
Journal of Microbiology Immunology and Infection
Journal of Microbiology Immunology and Infection IMMUNOLOGY-INFECTIOUS DISEASES
CiteScore
15.90
自引率
5.40%
发文量
159
审稿时长
67 days
期刊介绍: Journal of Microbiology Immunology and Infection is an open access journal, committed to disseminating information on the latest trends and advances in microbiology, immunology, infectious diseases and parasitology. Article types considered include perspectives, review articles, original articles, brief reports and correspondence. With the aim of promoting effective and accurate scientific information, an expert panel of referees constitutes the backbone of the peer-review process in evaluating the quality and content of manuscripts submitted for publication.
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