Epidemiology and risk factors for short-term outcomes of yeast bloodstream infection—A five-year retrospective analysis

LIU Xiao-Ying1, WU Lin2, CHEN Ying1, YANG Zhi-Tao1,3, ZHOU Min4, LI Jie4, MAO En-Qiang1, CHEN Er-Zhen1

Journal of Microbes and Infections ›› 2013, Vol. 8 ›› Issue (4) : 234-243.

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Journal of Microbes and Infections ›› 2013, Vol. 8 ›› Issue (4) : 234-243.
Article

Epidemiology and risk factors for short-term outcomes of yeast bloodstream infection—A five-year retrospective analysis

  • LIU Xiao-Ying1, WU Lin2, CHEN Ying1, YANG Zhi-Tao1,3, ZHOU Min4, LI Jie4, MAO En-Qiang1, CHEN Er-Zhen1
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Abstract

Yeasts, especially Candida, are important pathogens causing bloodstream infections (BSIs), responsible for significant mortality and morbidity among hospitalized patients. The present paper aims to report the current epidemiology of yeast BSI in Ruijin Hospital from January 2008 to December 2012, and to estimate the impact of appropriate antifungal therapy on the outcomes. The incidence of nosocomial yeast BSI was 0.34 episodes /1 000 hospitalized patients, and the overall crude 28-day mortality rate was 27.1%. The proportion of yeast BSI caused by non- Candida albicans (C. albicans)(65.1%) including C. parapsilosis (18.6%), C. tropicalis (14.0%), C. glabrata (7.0%), C. guilliermondii (5.4%) and C. sake (4.7%) was higher than that of C. albicans (34.9%). Among 129 cases of yeast BSI, 78.3% (101 cases) received empiric antifungal therapy of which only 69.8% (90 cases) were considered appropriate, while 21.7% (28 cases) did not receive any antifungal agent. The mortality was significantly lower in those who received appropriate empiric antifungal therapy compared with those who received inappropriate empiric antifungal therapy (20.0% vs. 43.6%, P=0.006) within 5 d of the onset. The age (HR=1.036, P=0.005) and neutropenia <500/mm3 (HR=15.497, P<0.001) were independent risk factors for 28-day mortality, while appropriate empiric antifungal therapy (HR=0.325, P=0.002) was protective factor. Appropriate empiric antifungal therapy influenced the short-term survival.

Key words

Fungus / Candida / Bloodstream infection / Mortality / Appropriate empiric antifungal therapyantifungal therapy  

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LIU Xiao-Ying1, WU Lin2, CHEN Ying1, YANG Zhi-Tao1,3, ZHOU Min4, LI Jie4, MAO En-Qiang1, CHEN Er-Zhen1. Epidemiology and risk factors for short-term outcomes of yeast bloodstream infection—A five-year retrospective analysis[J]. Journal of Microbes and Infections. 2013, 8(4): 234-243
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