Chinese Hospital Study Finds C. albicans Most Common in Candidemia, Mortality High in ICU

A 10-year retrospective analysis at a tertiary hospital in eastern China found that Candida albicans remains the leading cause of bloodstream Candida infections, with an overall in-hospital mortality of 33.85 percent and the intensive care unit (ICU) as the most frequent patient location.

The study, which examined 387 inpatients with candidemia from 2015 to 2024, reported a cumulative incidence of 0.214 per 1,000 inpatients. The ICU accounted for 55.30 percent of cases. C. albicans was the predominant pathogen (31.27 percent), followed by Candida glabrata (25.58 percent), Candida parapsilosis complex (21.44 percent), and Candida tropicalis (18.60 percent).

Ward-specific analysis showed that C. albicans was most frequent in the ICU (34.11 percent) and infectious disease wards (50.00 percent), whereas C. glabrata predominated in urology (52.17 percent) and pancreatic surgery (41.18 percent) wards. In Hematology, C. tropicalis was the primary pathogen (66.67 percent).

Most C. albicans and C. parapsilosis isolates were susceptible (> 90 percent) to all nine antifungals tested. C. tropicalis exhibited relatively high resistance or non-wild-type patterns (18.06 percent to 69.44 percent) to four azoles, including 27.78 percent cross-resistance to fluconazole and voriconazole.

Independent risk factors for in-hospital mortality included age 63 years or older (HR = 1.530), ICU admission (HR = 2.005), and acute or chronic renal failure (HR = 1.849). C. parapsilosis complex infection (HR = 0.456) and receipt of antifungal therapy (HR = 0.313) were associated with lower mortality risk.

The findings underscore the need for tailored management and prevention strategies based on local pathogen profiles, antifungal susceptibility, and specific mortality risk factors.