Study on the morbidity and pathogens of patients with candidemia at the intensive care unit / 中华流行病学杂志

ABSTRACT

Objective To study the mortality and pathogens of candidemia in patients at hospital intensive care unit(ICU).Methods Clinical data of candidemia cases admitted to ICU of the First Affiliated Hospital of Zhejiang University in recent five years were analyzed retrospectively.Chi-square test and logistic regression analysis were used.Results A total of 6034 patients were discharged in the ICU over the 5-year period.and 75 were diagnosed as candidemia.The annual morbidity rates of candidemia from 2002 to 2006 were 0.67%,1.46%,1.21%,1.15% and 1.56%, respectively.36 cases died of the disease,with the mortality as 48%.The annual mortality rates from 2002 to 2006 were 50%,64%,33%,41% and 52%,respectively.In this period,78 positive blood culture samples strains from ICU were identified as Candida,among which Candida albicans, C.glabrata,C.tropicalis,C.parapsilosis and C.lusitaniae accounted for 46.2%,21.7%,17.9%,12.8% and 1.3%, respectively.Average APACHE Ⅱ scores of the patients with candidemia were 17.21±4.38(range9-27).During the 5-year period,the annual morbidity of candidemia had increased from 0.67%to 1.56% while the ratios of candidemia due to non-albicans Candida species(NAC)increased from 50.0%to 56.5%.When analyzing the C.albicans group and NAC group with single factor and multiple conditional logistic regression method.we found that age(66±14 vs.53±16,P=0.001,OR=1.077,95% CI1.031-1.124)and hypoproteinemia(61.8% vs.81.6%, P=0.033,OR=0.206,95%CI0.048-0.880)both showed statistical significance.Conclusion Candidemia cases in ICU increased gradually and causing higher mortality.The number of patients with candidemia caused by NAC increased in recent 5 year.Age was proved to be a risk factor for those candidemia caused by C.albicans.Hypoproteinemia was proved to be risk factors for the candidemia caused by NAC.