Objective: To analyze the clinical characteristics of patients with candidemia for better clinical diagnosis and management of the disease.
Method: A retrospective study was carried out in 122 patients with confirmed diagnosis of candidemia from January 2010 to June 2014 in West China hospital of Sichuan University. The clinical features, risk factors, laboratory tests, treatments and clinical outcomes were reviewed and analyzed.
Results: The clinical symptoms mainly include chill, shivering and fever (moderate fever or high fever). A total of 85 patients (69.7%) complicated with more than or equal to two kinds of underlying diseases, and 108 patients (88.5%) have more than or equal to three risk factors.There were 82.8% patients with increased white blood cell counts, 49.2% patients with elevated aminotransferase levels and 41.0% patients with increased creatinine levels. The isolated strains were albicans (42, 34.6%), tropicalis (32, 26.2%), glabrata (23, 18.9%) and parapsilosis (18, 14.8%). Susceptibility tests indicated some strains were resistant to antifungal drugs. Sixty-seven patients were cured or improved, 55 died or discharged voluntarily. The mortality rate was 45.1%. The multivariate Logistic regression analysis showed the independent correlative factors of mortality were mechanical ventilation (OR=4.9, P=0.02), malignancy (OR=11.39, P=0.01) and diabetes (OR=5.93, P=0.02). Early empiric anti-fungal therapy helped reduce the fatality rate (OR=0.12, P=0.03).
Conclusion: Actively treating underlying diseases can improve the clinical effect. The key to decrease the mortality is appropriate antifungal chemotherapy.