An 11-Year retrospective analysis of candidiasis epidemiology, risk factors, and antifungal susceptibility in a tertiary care hospital in China.

Abstract

Candidiasis poses a significant threat to human health, especially in immunocompromised patients. However, there is a paucity of epidemiological data concerning the prevalence of candidiasis in developing regions of China. We conducted a retrospective study on patients positive for Candida infections in a tertiary care hospital in Shantou, China, to identify the clinical characteristics and risk factors for candidiasis. Of 5,095 cases of candidiasis, 489 (9.59%) were candidemia infections. Candida albicans (n = 230, 47.0%) was the predominant species identified among all patients. Non-albicans Candida (NAC) was more prevalent in adult patients, while Candida glabrata was slightly more frequent in pediatric patients (n = 10, 14.7%). Pulmonary diseases (n = 200, 47.8%) were the most common underlying comorbidities in adult patients (n = 25, 35.2%). Thrombocytopenia was the only laboratory finding higher in adult patients than in pediatric patients. Respiratory dysfunction, the presence of a central venous catheter, septic shock, and thrombocytopenia were independent risk factors for candidemia-related 30-day mortality. Amphotericin B exhibited high efficacy (100%), and itraconazole exhibited the lowest efficacy against all tested Candida isolates. C. glabrata had a lower susceptibility to azole, although this was not statistically significant. The epidemiological data on candidiasis, specifically candidemia in pediatric and adult patients, varied regarding the prevalence of Candida species and associated risk factors. This study provides guidance for prescribing the appropriate therapy and yields insights into the susceptibility patterns of different Candida isolates to antifungal drugs.