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[Clinical analysis of candidemia in immunocompetent patients]

Y L Ding1, N Shen1, Q T Zhou1

  • 1Department of Respiratory Medicine, Peking University Third Hospital, Beijing 100191, China.

Beijing Da Xue Xue Bao. Yi Xue Ban = Journal of Peking University. Health Sciences
|December 19, 2018
PubMed

Insights

Non-immunocompromised patients with candidemia are critically ill, often requiring ICU care and mechanical ventilation, and have a poorer prognosis compared to HIV-negative immunocompromised patients. Microbiological characteristics remain similar between groups.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Mycology

Background:

  • Candidemia, a serious bloodstream infection, poses significant challenges in clinical management.
  • Understanding the distinct characteristics of candidemia in different patient populations is crucial for targeted interventions.

Purpose of the Study:

  • To investigate the etiological and clinical features of candidemia in immunocompetent patients.
  • To compare the clinical profiles and outcomes of non-immunocompromised (NIC) versus HIV-negative immunocompromised (IC) candidemia patients.

Main Methods:

  • Retrospective analysis of clinical and microbiological data from 62 candidemia patients (2010-2016).
  • Comparison of underlying diseases, colonization, clinical manifestations, treatment, and outcomes between NIC and HIV-negative IC groups.
  • Assessment of severity using APACHE II and SOFA scores.

Main Results:

  • NIC patients (n=30) were more critically ill, with higher rates of ICU admission (63.3%), diabetes/hyperglycemia (70%), and mechanical ventilation (73.3%) compared to HIV-negative IC patients (n=32).
  • NIC patients exhibited significantly higher APACHE II and SOFA scores at admission and onset of candidemia.
  • Crude mortality was significantly higher in NIC patients (70%) than in HIV-negative IC patients (43.75%).
  • Candida albicans was the most prevalent isolate; clinical and microbiological characteristics were similar between groups.

Conclusions:

  • Candidemia in NIC patients is associated with greater critical illness, higher prevalence of diabetes/hyperglycemia, and increased need for mechanical ventilation.
  • NIC patients with candidemia experience a poorer prognosis compared to their HIV-negative IC counterparts.
  • Despite clinical differences, etiological and microbiological profiles of candidemia are comparable between NIC and HIV-negative IC patients.
Abstract

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