Candida species distribution, antifungal susceptibility and trends causing candidemia: a 10-year observation in...

Candidemia is a major global public health problem due to the high mortality rates and increasing antifungal resistance. This study investigated the epidemiology and risk factors of candidemia in eastern China over the past 10 years.

A descriptive, cross-sectional study was conducted from January 2015 to December 2024 in the Affiliated Hospital of Qingdao University to investigate the possible routes and risk factors of candidemia. Antifungal susceptibility was determined using broth microdilution method.

The incidence of candidemia increased from 0.98% to 1.69% over the past 10 years. In total 276 candidemia cases, Candida parapsilosis was the most prevalent species (32.2%), followed by Candida albicans (31.9%) and Candida tropicalis (21.5%). C. albicans and C. parapsilosis were susceptible to antifungal agents (resistance rate <7%). Candida tropicalis and Nakaseomyces glabratus exhibited higher resistance rates to itraconazole (18.6% and 13%) and fluconazole (18.6% and 30.4%), respectively. Multivariate analysis identified hypertension (P < 0.001), diabetes mellitus (P = 0.042), chronic pulmonary diseases (P = 0.021), hematological malignancy (P = 0.012), solid organ tumor (P = 0.031), surgery (P < 0.001), prior antibiotic administration (P < 0.001) and intravascular catheters (P = 0.03), ICU admission (P < 0.001), mechanical ventilation (P = 0.02), and total parenteral nutrition (P < 0.001) as independent risk factors of candidemia.

The incidence of candidemia has increased in recent years, with C. parapsilosis being the most prevalent species in candidemia. Effective strategies are needed to prevent candidemia from becoming a major concern.