Mortality and risk factor analysis for Candida blood stream infection: A multicenter study

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Clinical Microbiology

Background:

• Candida bloodstream infection (candidemia) is a severe systemic infection often acquired during intensive medical care.
• Mortality in candidemia is influenced by patient conditions, causative species, and treatment timeliness.
• Identifying mortality risk factors is crucial for improving patient outcomes.

Purpose of the Study:

• To retrospectively analyze mortality-related risk factors in adult candidemia cases.
• To investigate the impact of patient demographics, predisposing conditions, and treatment strategies on 30-day mortality.
• To identify protective factors and risk factors for candidemia survival.

Main Methods:

• Retrospective analysis of 289 adult candidemia cases from April 2011 to March 2016 across five Japanese hospitals.
• Bivariate and multivariate logistic regression analyses were performed.
• Factors examined included causative Candida species, patient predisposing conditions, empiric antifungal drug choice, and time to appropriate treatment.

Main Results:

• Overall 30-day mortality was 27.7%.
• Risk factors for mortality included advanced age (≥65 years) and high Sequential Organ Failure Assessment (SOFA) scores (≥6).
• Protective factors against mortality were community-acquired candidemia, *C. parapsilosis* infection, obtaining follow-up blood cultures, and empiric fluconazole treatment.

Conclusions:

• Candidemia patients with advanced age and poor health require close monitoring.
• Obtaining follow-up blood cultures is associated with an improved prognosis.
• Empiric fluconazole treatment may be a protective strategy for certain candidemia cases.