Abstract
The incidence of mixed candida/bacterial blood infections (BSIs) has been reported to account for 20% of all cases of candidaemia. However, its clinical characteristics and implications in patients with hematological diseases are not clear. We conducted a retrospective case-control study of hematological patients complicated with candidaemia over the past 5-year period to identify the risk factors and clinical implications of mixed candidia/bacterial BSIs (case group) vs. monobacterial candidiasis (control group). Of all 65 enrolled patients with candidaemia, 20 cases (30.8%) met the diagnostic criteria for mixed candida/bacterial BSIs. Candida tropicalis was the most common candida species in all patients. Klebsiella pneumoniae was the most detected bacteria (35%) in case group. Previous hospital stay ≥ 28 days, organic damage during candidaemia, and positive procalcitonin (PCT) test were the risk factors of mixed candida/bacterial BSIs. Cumulative mortality of all patients enrolled was 26.2% at day 30, with significant differences between case and control group. In multivariate analysis, organic damage and granulocyte recovery were the two predictive factors for 30-day mortality. Mixed candida/bacterial BSIs are fatal complications of infection which account for a considerable part of candidaemia; multicenter and large-scale clinical studies are required in the future.
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Funding
This study was financially supported by the National Natural Science Foundation of China (81730003), the National Key R&D Program of China (2017YFA0104502, 2017ZX09304021), the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD), the Jiangsu Medical Outstanding Talents Project (JCRCA2016002), the Jiangsu Provincial Key Medical Center (YXZXA2016002), and the Innovation Capability Development Project of Jiangsu Province (BM2015004).
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All procedures performed in studies involving human participants were in accordance with the ethical standards of The First Affiliated Hospital of Soochow University Ethics Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Chen, XC., Xu, J. & Wu, DP. Clinical characteristics and implications of mixed candida/bacterial bloodstream infections in patients with hematological diseases. Eur J Clin Microbiol Infect Dis 39, 1445–1452 (2020). https://doi.org/10.1007/s10096-020-03863-2
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DOI: https://doi.org/10.1007/s10096-020-03863-2