The Morbidity And Pathogens Of Patients With Candidemia In Intensive Care Unit

Objective To investigate the mortality and pathogens of patients with candidemia in intensive care unit(ICU).Methods The 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 candidemia.The annual morbidity of candidemia from 2002 to 2006 was 6.7%,1.46%,1.21%,1.15%and 1.56%,respectively.Death of 36 cases occurred with the mortality of 48%.The annual mortality from 2002 to 2006 was 50%,64%,33%, 41%and 52%,respectively.In this period 78 positive blood culture samples strains from ICU were Candida,among which C.albicans,C.glabrata,C.tropicalis, C.parapsilosis and C.lusitaniae account for 46.2%,21.7%,17.9%,12.8%and 1.3%, respectively.Average ApacheⅡscores of the patients with candidemia were 17.21±4.38(range:9-27).During 5-year period the annual morbidity of candidemia increased from 0.67%to 1.56%,the ratios ofcandidemia due to non-albicans Candida species(NAC)increased from 50%to 56.5%.Analyzed C.albicans group and NAC group with single factor and multiple conditional logistic regression method,we found age(66±14 vs.53±16,P=0.001,OR=1.077,95%CI 1.031-1.124)and hypoproteinemia(61.8%vs.81.6%,P=0.033,OR=0.206,95%CI 0.048-0.88)both have statistical significance.Conclusion Candidemia cases in ICU increased gradually and lead to higher mortality. The candidemia caused by NAC increased in recent 5 year.Age was proved to be risk factors for the candidemia caused by C.albicans.Hypoproteinemia was proved to be risk factors for the candidemia caused by NAC.