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• W4308078041 abstract "Abstract Background: Data on persistent candidemia (PC), a recognized complication of candidemia, are lacking in China. This study aimed to investigate the clinical characteristics and risk factors for the mortality of PC among adults in China. Methods: This 6-year retrospective study analyzed the prevalence, species distribution, antifungal susceptibility, risk factors, and patient mortality of PC among adults in three regional tertiary teaching hospitals in China from 2016 to 2021. PC was defined as the isolation of the same Candida species from positive blood culture for ≥5 days following the initiation of antifungal therapy. Results: The definition of PC was fulfilled by 36 patients (13.7%, 36/263). The mean age of the patients was 59.9 years (60 years for patients with PC; 59.8 years for those with non-PC; P > 0.05), and 131 (60.1%) were men [16 with PC (44.4%), 115 with non-PC (63.2%), P < 0.05]. The mean annual incidence was 0.15/1000 admissions (including PC 0.03/1000 admissions vs non-PC 0.12/1000 admissions, P < 0.05). Candida parapsilosis (14/36, 38.9%) and Candida albicans (81/182, 44.5%) were the predominant pathogens in patients with PC and non-PC, respectively. Most isolates were susceptible to flucytosine (99.0%) and amphotericin B (99.5%), and the activity of antifungal agents against Candida species was not statistically significantly different between patients with PC and non-PC ( P > 0.05). The 30-day mortality rate was 20.2% (16.7% with PC vs 20.9% with non-PC, P > 0.05). Multivariable regression analysis showed that use of broad-spectrum antibiotics, and fluconazole were independent predictors of PC, sex (male) was the protective factor for PC. Respiratory dysfunction and length of hospital stay were independent predictors of 30-day mortality in patients with non-PC. C. tropicalis bloodstream infection (odds ratio, 12.642; 95% confidence interval, 1.059–150.951; P = 0.045) was an independent predictor of 30-day mortality in patients with PC. Conclusions: The epidemiological data of patients with PC and non-PC were different in the distribution of Candida species, the mean annual incidence, and independent predictors of 30-day mortality. Flucytosine and amphotericin B could be used as first-choice drugs in the presence of PC infections." @default.
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• W4308078041 date "2022-11-03" @default.
• W4308078041 modified "2023-10-16" @default.
• W4308078041 title "Epidemiology, antifungal susceptibility, risk factors, and mortality of persistent candidemia in adult patients in China: A multicenter retrospective study" @default.
• W4308078041 doi "https://doi.org/10.21203/rs.3.rs-2217465/v1" @default.
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