Objective: To study the mortality and pathogens of candidemia in patients at hospital intensive care unit (ICU).
Methods: Clinical data of candidemia cases admitted to ICU of the First Affiliated Hospital of Zhejiang University in recent five years were analyzed retrospectively. Chi-square test and logistic regression analysis were used.
Results: A total of 6034 patients were discharged in the ICU over the 5-year period, and 75 were diagnosed as candidemia. The annual morbidity rates of candidemia from 2002 to 2006 were 0.67%, 1.46%, 1.21%, 1.15% and 1.56%, respectively. 36 cases died of the disease, with the mortality as 48%. The annual mortality rates from 2002 to 2006 were 50%, 64%, 33%, 41% and 52%, respectively. In this period, 78 positive blood culture samples strains from ICU were identified as Candida, among which Candida albicans, C. glabrata, C. tropicalis, C. parapsilosis and C.lusitaniae accounted for 46.2%, 21.7%, 17.9%, 12.8% and 1.3%, respectively. Average APACHE II scores of the patients with candidemia were 17.21 +/- 4.38 (range: 9-27). During the 5-year period, the annual morbidity of candidemia had increased from 0.67% to 1.56% while the ratios of candidemia due to non-albicans Candida species (NAC) increased from 50.0% to 56.5%. When analyzing the C. albicans group and NAC group with single factor and multiple conditional logistic regression method, we found that age (66 +/- 14 vs. 53 +/- 16, P = 0.001, OR = 1.077, 95% CI: 1.031- 1.124) and hypoproteinemia (61.8% vs. 81.6%, P = 0.033, OR = 0.206, 95% CI: 0.048-0.880) both showed statistical significance.
Conclusion: Candidemia cases in ICU increased gradually and causing higher mortality. The number of patients with candidemia caused by NAC increased in recent 5 year. Age was proved to be a risk factor for those candidemia caused by C. albicans. Hypoproteinemia was proved to be risk factors for the candidemia caused by NAC.