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cohort·infectious disease, epidemiology, internal medicine, oncology, critical care·PMC10311694

Different epidemiological characteristics between patients with non-hospital-onset and hospital-onset candidemia: a retrospective cohort study

Epidemiology and Infection · 4 authors, 5 centres

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TL;DR

This 4-year retrospective cohort study of 339 adult patients with candidemia at a Taiwanese medical center compared non-hospital-onset (NHO) and hospital-onset (HO) cases. Patients with NHO candidemia had a significantly lower risk of in-hospital mortality compared to those with HO candidemia.

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A retrospective cohort study analyzed 339 adult patients with candidemia over four years at a tertiary medical center in Taiwan. The all-cause in-hospital mortality rate was 55.75%. Other mortality predictors included recent steroid use, retained chemo port, acute liver failure, and septic shock. Distinct microbiological characteristics were observed, with a higher proportion of C. glabrata in NHO cases and C. tropicalis in HO cases. Limitations include the retrospective design and lack of in-vitro resistance mechanism exploration.

STUDY TYPE

cohort

SPECIALTY

infectious disease

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ORIGINAL PAPER

PMC10311694

Different epidemiological characteristics between patients with non-hospital-onset and hospital-onset candidemia: a retrospective cohort study

Epidemiology and Infection

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ABSTRACT

Candidemia is a life-threatening infectious disease that has varying incidences. Previous studies revealed the differences in clinical characteristics and outcomes between non-hospital-onset (NHO) and hospital-onset (HO) candidemia. This 4-year retrospective research included adult patients with candidemia in a tertiary medical centre in Taiwan, and cases were categorised as NHO and HO candidemia. Survival analysis and risk factors associated with in-hospital mortality were performed using the Kaplan–Meier method and multivariate Cox proportional-hazards models. The analysis included 339 patients, and the overall incidence was 1.50 per 1,000 admission person-year. Of the cases, 82 (24.18%) were NHO candidemia, and 57.52% (195/339) of patients were diagnosed with at least one malignancy. C. albicans was the most commonly isolated species, accounting for 52.21%. Patients with NHO candidemia had a higher proportion of C. glabrata but a lower ratio of C. tropicalis in comparison to the HO group. The all-cause in-hospital mortality rate was 55.75%. Multivariate Cox proportional-hazards models showed that NHO candidemia was a better outcome predictor (adjusted hazard ratio, 0.44). The administration of antifungal therapy within 2 days was a protective factor. In conclusion, NHO candidemia showed distinct microbiological characteristics and a better outcome than HO candidemia.

CITATION EXPORT

Yung-Chun Chen, Mao-Wang Ho, Wen-Cheng Chao et al.. Different epidemiological characteristics between patients with non-hospital-onset and hospital-onset candidemia: a retrospective cohort study. Epidemiology and Infection. (2023). https://doi.org/10.1017/S0950268823000894

AUTHORS

4 · 5 CENTRES

Yung-Chun Chen, Mao-Wang Ho, Wen-Cheng Chao, Chao-Chin Chang

1Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
2Graduate Institute of Microbiology and Public Health, National Chung Hsing University, Taichung, Taiwan
3Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital and China Medical University, Taichung, Taiwan
4Department of Business Administration, National Changhua University of Education, Changhua, Taiwan
5Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan