Analysis The Distribution And Clinical Characteristic Of Fungemia Patients In The First Affiliated Hospital Of Guangxi Medical University From 2014 To 2019

Objective:To analyze the incidence,clinical features and the predisposing factors of fungemia,investigate the risk actors for poor outcome due to fungemia,and guide clinical treatment and hospital infection control.Methods:The date of all all patients with positive fungi blood culture who were visited the first affiliated hospital of Guangxi Medical University from January 1,2014 to December 31,2019 and discharge diagnose contained fungemia.The patients were divided into good outcome or bad outcome group according to prognosis.The patient’s gender,age,department,isolate pathogens,comorbidities,etc.were contained to analysis.Based on the results of univariate analysis,the data were analyzed using logistic multiple regression,and the significant differences of good outcome groud and bad outcome group were compared to determine prognostic risk factors.Results:A total of 502 patients with fungemia were included,including345 males and 157 females,with a median age of 51 years old.75 deaths,mortality rate of 14.9%.The first of the isolated fungal strains was Talaromyces Marneffei,151 strains,followed by Candida albicans 94 strains and Candida tropicalis 65 strains.In the analysis of in-patient departments,140 cases were in the Department of Intensive Medicine,which was the primary infection department.In a single factor analysis of 501 patients with fungemia,it was found that advanced age(≥60 years old),critical illness infection,PICC intubation,blood transfusion,HIV infection,and multiple organ failure were statistically significant in the good and bad outcome groups Based on the scientific differences,further multi-factor analysis found that multiple organ failure and critical illness infection are its risk factors.After grouping,multi-factor analysis showed that for patients in the ICU group,advanced age,central system diseases,and gastrointestinal system diseases were the prognostic risk factors;for patients in the non-ICU group,blood system diseases and central system diseases were their Prognostic risk factors;for patients in the HIV group,gastrointestinal disease is the prognostic risk factor,and the infection strain is T.marneffei as its prognostic protective factor;for patients in the non-HIV group,the infection department is ICU.Pulmonary infection is the prognostic risk factor;for infectious diseases group,HIV infection is the protective factor for prognosis;for non-infectious disease group,hepatobiliary system diseases,lung infection and central nervous system diseases are the prognostic risk factors.Conclusions: The fungemia patients in our hospital are predominantly middle-aged males,and the patients are distributed in ICU,respiratory and critical care subjects,pediatrics,and hematology.Infected strains are mainly T.marneffei,and some Candida.The resistance rate of conazole for candida is the highest.For patients with fungemia in our hospital,multiple organ failure and infection department is the ICU is the main risk factor affecting its prognosis.HIV infection is a protective factor in patients with fungemia in infectious diseases department.