Abstract:A 51-year-old male patient was admitted with massive flame burns.By post-burn day 20,progressive tissue necrosis had developed in limb wounds.Metagenomic next-generation sequencing(mNGS)of wound exudates confirmed mucormycosis.Through the treatment of amphotericin B colloidal dispersion complex combined with wound debridement and dressing change,amputation of both lower extremities and skin grafting of the wound,most of the patient's wounds were effectively covered.However,the patient succumbed on post-burn day 57 due to hematogenous dissemination of Mucorales species with consequent fungal emboli in major arterial vessels,following family's decision to withdraw life-sustaining therapies.Although the patient eventually died,a series of targeted treatment measures might provide a reference for the treatment of such patients after they developed extensive mucormycosis infections all over their body.

Abstract:A case of diffuse pulmonary cryptococcosis in a middle-aged female without identified definite immunosuppressive factors is reported.The patient presented with a five-month history of recurrent cough.Chest CT revealed progression from scattered pulmonary nodules to diffuse bilateral infiltrates.Serum cryptococcal capsular polysaccharide antigen testing was strongly positive,while conventional pathogen testing of bronchoalveolar lavage fluid was negative.However,Cryptococcus neoformans sequences were rapidly detected via metagenomic next-generation sequencing(mNGS).After central nervous system involvement was ruled out,the patient was treated with oral fluconazole for six months and subsequently achieved full recovery.This case highlights the potential value of mNGS as a rapid and accurate diagnostic adjunct when imaging is atypical and conventional tests are inconclusive,facilitating timely and targeted therapy to improve prognosis.

Abstract:Objective This study aims to explore the epidemiology,pathogen distribution,drug sensitivity,and death related risk factors of patients with candidemia in the Nanjing area,providing a basis for clinical treatment of candidemia.Methods A retrospective analysis was conducted on the demographic and clinical data of 393 patients with candidemia at the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2024.Univariate and multivariate logistic regression were used to analyze the risk factors for patient mortality.Results From 2015 to 2024,the average incidence rate of candidaemia was 0.214/1000 inpatients,and the mortality rate was 33.33%.Candida albicans accounted for 30.79%,whereas non-C.albicans accounted for 69.21%.Non-C.albicans were dominated by C.glabrata(25.19%),C.parapsilosis complex(22.65%),and C.tropicalis(18.32%).One strain of C.auris(0.25%)was isolated.The drug sensitivity results showed that C.albicans and C.parapsilosis had a sensitivity rate of about 90%to azole drugs,while C.tropicalis had sensitivity rates of 66.7%and 58.3%(27.78%cross resistance)to fluconazole and voriconazole,respectively.All Candida strains exhibit wild-type phenotype against amphotericin B.Multivariate logistic regression analysis showed that age≥62 years,chronic renal failure,mechanical ventilation,and ICU admission were independent risk factors for patient mortality.Compared to infections with other Candida strains,patients infected with the Candida parapsilosis complex had a lower risk of mortality.Conclusion There are differences in the epidemiological characteristics of candidemia in Nanjing areas compared to other regions in China,and caution should be exercised regarding the occurrence of C.Auris.The mortality rate of adult patients with candidemia is relatively high.Clinically,targeted treatment and prevention strategies should be developed based on the distribution of pathogenic fungi,drug sensitivity characteristics,and risk factors for death in the local area.It is recommended that early screening and prophylactic antifungal therapy be implemented for patients at high risk,including those with advanced age,chronic renal failure,mechanical ventilation,or ICU admission,to mitigate the incidence of invasive fungal infections.

Abstract:A case of fingernail onychomycosis caused by Aspergillus oryzae is reported.A 21-year-old female whose proximal end of the middle fingernail on right hand had thickened and turned yellowish-white for more than a year.In the past two months,the nails on the middle and ring fingers of left hand had also been affected.Diseased nail clippings were collected for fungal fluorescence staining microscopy,which yielded positive results for hyphae.Fungal culture and strain identification confirmed the Aspergillus oryzae.The patient achieved complete cure after receiving oral itraconazole pulse therapy for 3 months.

Abstract:Objective To investigate the expression levels of galactomannan(GM),adenosine deaminase(ADA),C-reactive protein(CRP)and serum amyloid A(SAA)in HIV-infected patients complicated with Talaromyces marneffei(TM)infection,as well as their clinical diagnostic value,and to analyze the related influencing factors.Methods A retrospective study was conducted on 50 HIV-infected patients complicated with TM infection admitted to Mengchao Hepatobiliary Hos-pital of Fujian Medical University from October 2023 to April 2025,who were enrolled as the observation group.Another 50 HIV-infected patients without any fungal infection during the same period were selected as the control group.The levels of GM,ADA,CRP and SAA were compared between the two groups.Multivariate logistic regression analysis was used to identify independent risk factors,receiver operating characteristic(ROC)curve was employed to evaluate diagnostic efficacy,and Pearson correlation coefficient was adopted to assess the correlation among the indicators.Results There were no statis-tically significant differences in gender and age between the two groups(P>0.05).The levels of GM,ADA,CRP and SAA in the observation group were significantly higher than those in the control group(P<0.05).Multivariate logistic regression anal-ysis showed that GM(OR=5.149,95%CI:4.318-10.246),ADA(OR=1.004,95%CI:1.022-1.066),CRP(OR=1.808,95%CI:1.380-2.370)and SAA(OR=1.325,95%CI:1.029-1.706)were all independent risk factors for TM infection in HIV-infected patients(P<0.05).ROC curve analysis indicated that GM(AUC=0.979,95%CI:0.950-1.000),ADA(AUC=0.731,95%CI:0.631-0.832),CRP(AUC=0.948,95%CI:0.898-0.997),SAA(AUC=0.965,95%CI:0.918-1.000)and their combined detection(AUC=0.985,95%CI:0.959-1.000)all had significant predictive value for HIV complicated with TM infection(P<0.05).Pear-son correlation coefficient analysis revealed that there were positive correlations among GM,ADA,CRP and SAA(P<0.05).Conclusion The levels of GM,ADA,CRP and SAA are significantly elevated in HIV-infected patients complicated with TM infection,and all of them are independent risk factors.The diagnostic efficacy of combined prediction is higher than that of single indicator prediction,and there are positive correlations among these indicators.By jointly detecting the levels of GM,ADA,CRP and SAA,clinicians can more efficiently identify high-risk patients,formulate individualized treatment plans,and timely adjust strategies according to changes in indicators,ultimately improving the prognosis of patients.

Abstract:Objective To investigate the risk factors associated with peptic ulcer(PU)combined with fungal infections in children and the application of targeted protective measures.Methods A retrospective study was conducted involving 21 children with peptic ulcer and fungal infection(infection group)and 63 matched non-infected peptic ulcer controls(1∶3 ratio)admitted between February 2023 and February 2025.Clinical data were collected,and risk factors for fungal infection were identified using multivariable logistic regression.Predictor accuracy was evaluated via ROC analysis,and a decision tree model was constructed based on the identified factors.Targeted protective interventions were implemented,and changes in eating behavior were assessed using the SCEBS score before and after intervention.Results A total of 26 strains of fungi were detected in 21 children with PU combined with fungal infections in this study,of which 22 strains of Candida albicans(84.62%)were predominant.The results of multifactorial logistic regression showed that ulcer maximum diameter,hospital stay(>15 d),combination of more than 2 antimicrobial drugs,application of broad-spectrum antimicrobial drugs for>2 weeks,and CRP were the independent risk factors for PU-combined fungal infections(P<0.05).AUC=0.998,95%CI(0.994-1.000)for the joint test revealed that the following factors as ulcer maximum diameter,hospital stay(>15 d),combination of more than two antimicrobial drugs,application of broad-spectrum antimicrobial drugs>2 weeks,CRP,and joint prediction of PU combined with fungal infection were statistically significant(P<0.05)according to ROC analysis.Of these,CRP was the most significant predictor,and the model's classification accuracy was 100.00%.After four weeks of intervention,children with peptic ulcer complicated with fungal infection had higher SCEBS scores than they had before,and the difference was statistically significant(P<0.05).Conclusion C.albicans is the main causative species of fungal infections in children with PU,and the maximum diameter of ulcers,length of hospitalisation(>15 d),use of more than 2 antimicrobial drugs,application of broad-spectrum antimicrobial drugs for>2 weeks,and CRP are important risk factors for fungal infections in children with PU.Clinical attention should be paid to the early conduct of drug sensitivity tests and selection of antimicrobial drugs according to the results,so as to provide children with targeted measures of protection,in order to improve the clinical symptoms and promote the recovery of children.

Abstract:Objective To investigate the species of pathogen,drug resistance and influencing factors of 1128 patients with superficial fungal diseases in the Hebei Petroleum Central Hospital from 2021-2023.Methods The 1128 patients with superficial fungal diseases in Hebei Zhongyang Petroleum Center Hospital from January 2021 to December 2023 were as a case group,and the selected 483 patients with non-fungi infectious in the hospital during the same period were as a control group.The types of superficial fungal diseases,pathogen and the drug resistance of the main pathogen were analyzed,the clinical data of the two groups were compared,and the risk factors for the occurrence of superficial fungal diseases were analyzed by multifactorial logistic regression.Results Among the 1128 cases of superficial fungal diseases,455 cases(40.34%)of nail fungal diseases,268 cases(23.76%)of tinea cruris,213 cases(18.88%)of tinea corporis,169 cases(14.98%)of tinea cruris,and 23 cases(2.04%)of tinea cephalicis were detected.A total of 1128 strains of causative fungi were culturally isolated from the 1128 patients with superficial fungal diseases,of which 871 strains of dermatophytes(77.22%),233 strains of yeasts(20.66%),and 24 other strains(2.13%).Among the 1128 strains of pathogen detected,425 strains(37.68%)of Trichophyton rubrum,254 strains(22.52%)of T.interdigital,and 144 strains(12.77%)of Candida albicans were detected more frequently.Among them,the resistance rates of T.rubrum and T.interdigital to fluconazole,amphotericin B and itraconazole were 69.18%,54.59%,9.18%and 72.05%,41.34%,4.72%,respectively,and the resistance rates of C.albicans to fluconazole,amphotericin B and itraconazole were 6.25%,2.78%and 2.08%,respectively,and all 3 species of fungi were sensitive to terbinafine.The percentage of cases with history of fungal diseases,history of trauma,poor living habits,long-term exposure to animals/poultry,and long-term use of antimicrobial drugs were higher in the case group than that in the control group(P＜0.05).Multifactorial logistic regression analysis showed that history of fungal diseases(OR=2.188),history of trauma(OR=2.002),accompanied by poor living habits(OR=2.550),long-term exposure to animals/poultry(OR=3.077),and long-term use of antimicrobial drugs(OR=2.901)were all risk factors for the development of superficial mycosis(P＜0.05).Conclusion In 2021-2023,superficial fungal diseases in Hebei Central Petroleum Center Hospital were dominated by nail fungal diseases,and the pathogen of patients were detected more frequently in T.rubrum,T.interdigitale and C.albicans,and the resistance characteristics of different fungi to different antimicrobial drugs were different,and history of fungal diseases,history of trauma,poor living habits,long-term exposure to animals/poultry,and long-term use of antimicrobial drugs were closely related to the occurrence of superficial fungal diseases.

Abstract:Objective To investigate the species distribution,drug resistance characteristics and related risk factors of invasive Candida infections in the ICU,and to provide a basis for optimizing antifungal treatment regimens and preventing nosocomial infections in clinical practice.Methods The clinical data of patients with invasive candidiasis admitted to the ICU of Hebei Yanda Hospital from January 20,2021 to June 20,2025 were retrospectively collected.The Candida strains were re-identified and the minimum inhibitory concentrations(MICs)of 9 antifungal drugs were determined.Risk factors affecting patient prognosis were screened.Results A total of 40 invasive Candida strains were included,among which C.albicans was the most prevalent(45.00%),followed by C.parapsilosis complex(22.50%)and C.tropicalis(15.00%).The drug susceptibility results showed that C.albicans was sensitive to all antifungal drugs;the resistance rate of C.tropicalis to azole drugs was 16.7%;the resistance rate of C.parapsilosis complex to fluconazole was 44.4%;the MIC value of C.auris to fluconazole was>256 µg/mL.Multivariate analysis indicated that septic shock was an independent risk factor affecting patient prognosis.Conclusion Invasive Candida infections in the ICU are still mainly caused by C.albicans.C.tropicalis shows cross-resistance to azole drugs,C.parapsilosis complex has a relatively high resistance rate to fluconazole,and C.auris is highly resistant to fluconazole.Septic shock is a key risk factor for poor prognosis in patients.

Abstract:s]Objective To screen and validate inflammatory markers such as NLR and PLR for the prognosis of patients with Candida bloodstream infection,and to construct and validate a nomogram.Methods Collected laboratory results of patients with Candida bloodstream infections from Guangdong Provincial Second Hospital of Traditional Chinese Medicine from 2011 to 2024,and calculated eight inflammatory markers,including NLR,PLR,NPR,NPAR,and CLR.Based on patient survival status 28 days post-infection,patients were divided into a survival group(n=101)and a mortality group(n=51).Cox univariate analysis was used to compare the data of the two groups.Variables were screened using LASSO regression,and a nomogram model was constructed based on the results.Model performance was evaluated using receiver operating characteristic curve area,calibration curve,and clinical decision curve.Results The primary isolates from patients with different outcomes were similar,but the proportion of Candida glabrata isolates was significantly higher in the mortality group than which in the survival group.The resistance rates of isolates to fluconazole,voriconazole,and itraconazole were slightly higher in the mortality group than that in the survival group,but the differences were not statistically significant.A model was constructed using LASSO regression to select five variables:NLR,PLR,NPR,NPAR,and CLR.The model's C-index was 0.646,indicating it had a certain predictive capability.The total score of the nomogram increased with the decrease of NLR as well as the increase of PLR,NPR,NPAR,and CLR,while the survival probability decreased with increase of the total score.The area under the curve for the model's 7-day,14-day,and 28-day prognosis were 0.753,0.679,and 0.672,respectively.The highest discriminatory ability was observed for the 7-day prognosis.The calibration curve followed the midline at a 45-degree angle,indicating that the predictive model adequately reflected actual survival outcomes.The clinical decision curve showed that the model provided good net benefit within the 20%-50%risk threshold range for 7-day,14-day,and 28-day prognoses.Conclusion The prognostic prediction model constructed based on immune inflammatory markers such as NPAR and NLR provides a new tool for assessing the prognosis of patients with Candida bloodstream infection.The model demonstrates good performance in terms of discriminatory power,calibration ability,and clinical decision support,and is expected to be widely applied in clinical practice.

Abstract:The patient,a 60-year-old woman,was admitted to the hospital with chronic cough and sputum with dyspnea for 20 years,which had worsened in the past 2 months.Initially,broad-spectrum antibiotic piperacillin tazobactam was used for anti-infective treatment,and then Aspergillus fumigatus infection was diagnosed according to the results of the pathogenicity test,and voriconazole antifungal treatment was immediately added;because of recurrent fever and review of pathogenicity,and the results suggested that Rhizomucor pusillus infection,and then combined with amphotericin B antifungal treatment,and then the temperature returned to normal,and the condition gradually improved,but renal insufficiency was triggered after 2 weeks of anti-infective treatment,and the antifungal program was adjusted.After 2 weeks of anti-infection treatment,renal insufficiency was induced,and the antifungal regimen was adjusted,amphotericin B was stopped,and isavuconazole was added,and the clinical symptoms gradually improved.

Abstract:Objective High osmotic pressure signaling protein 1(Sho1)is ubiquitous on the cell membrane of fungi,and its structure is relatively conserved,which plays an important role in the pathogenic mechanism of fungi.However,the effect of Sho1 protein on the pathogenic ability of Candida albicans has not been reported.Therefore,establishing a method to construct SHO1 gene knockout strains of C.albicans will provide a theoretical basis for further exploration of the effect of Sho1 protein on the biological characteristics and pathogenicity of C.albicans.Methods SN152(His-/Leu-/Arg-)deficient strain was selected as the parental strain for gene knockout technology.Fusion PCR and homologous complementation of His and Leu plasmids were used to knock out the target gene rapidly and efficiently.The effect of Sho1 protein on the pathogenic ability of C.albicans was initially explored by crystal violet staining,polystyrene well plate model,and Gram staining oil microscope.Results his and fusion PCR-his gene knockout cassettes were constructed.leu and fusion PCR-leu gene knockout cassettes were transformed into SN152 by electroporation.SHO1 knockout strains were verified by PCR,agarose gel electrophoresis and gene sequencing.Our results suggested that SHO1 knockout decreased the ability of biofilm formation.Conclusion SHO1 gene knockout strain of C.albicans is successfully constructed.SHO1 gene knockout reduces the biofilm formation ability and pathogenicity of C.albicans.

Abstract:A 73-year-old woman presented with a one-month history of facial erythema and pruritic papules.The lesions initially developed around the perioral area and nasolabial folds without an apparent trigger.She was diagnosed with"dermatitis"at another hospital and treated with topical mometasone furoate cream,with no clinical improvement.One week before presentation at our hospital,she was diagnosed with"seborrheic dermatitis"and prescribed topical tacrolimus oint-ment,again with no therapeutic response.She subsequently returned for further evaluation.Comprehensive laboratory testing revealed a positive direct microscopic examination of facial scales,and fungal culture identified Trichophyton rubrum.A thorough physical examination further revealed clinical signs of tinea pedis and onychomycosis.Fungal culture confirmed T.rubrum infection at these sites as well.The final diagnoses were tinea faciei(atypical presentation),tinea pedis,and onycho-mycosis.The patient was treated with topical bifonazole cream combined with terbinafine cream twice daily to the face and feet.For the toenails,30%glacial acetic acid and topical amorolfine hydrochloride cream were applied.After two weeks of treatment,the facial lesions resolved completely,and the onychomycosis is currently under continued follow-up.

Abstract:A case of pulmonary mucormycosis was reported.The patient,female,45 years old,was admitted to the hospital due to"cough,expectoration,and dyspnea for more than 3 months,aggravated for 3 days".She had a medical history of"diabetes,coronary heart disease after coronary stent implantation",and was hospitalized in the local hospital for"pneumonia,diabetic ketoacidosis"three months ago.Chest CT showed multiple high-density shadows in both lungs,with local cavities(mainly in the upper and lower lobes of the right lung).After bronchoscopy lung tissue biopsy,mucormycosis was observed in the tissue,confirming the diagnosis of pulmonary mucormycosis.The patient was given repeated bronchoscopic intervention treatment,combined with amphotericin B antifungal treatment for 7 days.After discharge,the patient was treated with oral posaconazole suspension at a dose of 600 mg/d for 3 months.The symptoms of cough and dyspnea had disappeared.Regular follow-up chest CT scans showed that the lesions were gradually absorbing.A telephone follow-up was performed two years later.The patient's blood glucose was well-controlled,with no obvious symptoms of cough,expectoration or dyspnea,and the chest imaging findings remained stable.

Abstract:This report presented a case of surgical incision infection caused by Trichophyton rubrum.The patient,a 37-year-old male,developed delayed wound healing one month after surgery for a right calcaneal fracture.The wound secretion culture was positive for T.rubrum,which was further confirmed by ITS sequencing.The patient had a history of tinea pedis,and fungal culture of the skin flakes was consistent with the wound secretion,both showing T.rubrum.The treatment included oral fluconazole,topical terbinafine spray,and negative pressure wound therapy.The wound healed well at one-year follow-up,with no recurrence.

Abstract:Objective To evaluate the antifungal activity of isobavachalcone(IBC)against various Candida species,dermatophytes and Sporothrix in vitro.Methods The minimum inhibitory concentration(MIC)and minimum fungicidal concentration(MFC)of IBC were determined using the microdilution method,alongside commonly used antifungal drugs.The growth curves of Candida auris were plotted.Additionally,the effects of IBC on C.auris'growth and biofilm formation were investigated utilizing the XTT reduction assay,fluorescence staining,scanning electron microscopy,and transmission electron microscopy.Results Compared with other antifungal drugs,the MICs of IBC against various Candida species,dermatophytes and Sporothrix generally fell within the middle range.Notably,the MFC of IBC against most of the Candida species was found to be lower than that of other antifungal agents.Furthermore,IBC caused damage to the cell wall and membrane of C.auris,and its antifungal effects on growth and biofilm formation were concentration-dependent.Conclusion Isobavachalcone(IBC)emerges as a broad-spectrum and effective fungicidal agent,particularly exhibiting unique advantages in combating Candida infections.However,the safety of the drug must be established before its clinical implementation.

Abstract:A 48-year-old female patient with anti-IFN-γ autoantibody positive immune deficiency disease was reported.The patient presented with a 4-month history of cervical lymphadenopathy followed by progressive disseminated cutaneous papulonodular eruptions and recurrent fevers persisting for more than a month.After admission,the patient quickly developed multiple organ dysfunction syndrome,metagenomic next-generation sequencing(mNGS)was used.Talaromyces marneffei was detected in the puncture fluid of the left leg mass and the arm abscess,while histopathological examination of dorsal lesions demonstrated characteristic fungal elements.Concurrent laboratory investigations showed elevated(1,3)-β-D-glucan levels(G-test positivity).After diagnosis,amphotericin B and voriconazole were given for a full course of antifungal therapy.Herpes zoster occurred during treatment,and the patient improved with antiviral therapy and revised antifungal therapy.After a total of 12 weeks of systemic antifungal therapy,the patient achieved clinical cure during outpatient follow-up.

Abstract:A five-month-old girl presented with plaques on her right face for 2 months.The child began to develop red plaques on the right cheek 2 months ago.She was successively diagnosed as"dermatitis"and"skin infection".However,external use of glucocorticoid and antibiotics was ineffective,and the lesion gradually aggravated with local scab formation.Therefore,she came to the Children's Hospital Zhejiang University School of Medicine for medical treatment.Skin biopsy of the lesion was conducted.The fungal culture of the skin tissue was positive and morphologically identified as sporotrichosis.The histopathological examination of the skin lesion reveals epidermal damage,characterized by a disorganized arrangement of subcutaneous hair follicles and sebaceous glands,along with inflammatory infiltration composed predominantly of lymphocytes,plasma cells,and neutrophils.The final diagnosis was fixed sporotrichosis.The therapeutic efficacy of a 40-day oral itraconazole regimen was found to be suboptimal.It was cured by oral administration of 10%potassium iodide solution for 1.5 months.There was no recurrence during the six-month follow-up.

Abstract:Objective To investigate the independent risk factors for poor prognosis in patients with candidemia.Methods A retrospective analysis was conducted on clinical data of patients diagnosed with candidemia at Zhongda Hospital Affiliated to Southeast University from January 2020 to December 2024.Based on clinical outcomes,patients were divided into a favorable prognosis group and a poor prognosis group.Variables with a significance level of P<0.10 in univariate analysis were included in the multivariate logistic regression model to identify independent risk factors affecting prognosis.Odds ratio(OR)and its 95%confidence interval(CI)were calculated.Results A total of 104 patients were enrolled,including 60 with favorable prognosis and 44 with poor prognosis,resulting in a poor prognosis rate of 42.31%.The predominant pathogen was Candida albicans,accounting for 50.00%,followed by C.tropicalis,accounting for 19.23%.Antifungal susceptibility testing revealed high resistance rates to azoles in C.tropicalis and C.glabrata.Multivariate analysis identified intra-abdominal infection(OR=8.587,95%CI:1.538～47.941,P=0.014),drug-resistant bacterical infection(OR=5.116,95%CI:1.246～21.007,P=0.024)and hemorrhage(OR=5.930,95%CI:1.386～25.383,P=0.016)as independent risk factors for poor prognosis,while a longer duration of antifungal therapy(OR=0.858,95%CI:0.776～0.949,P=0.003)was a protective factor.Conclusion Intra-abdominal infection,drug-resistant bacterical infection,hemorrhage,and shorter duration of antifungal therapy are independent risk factors for poor prognosis in patients with candidemia.Clinical practice should emphasize the early identification of high-risk patients,prompt blood culture testing,optimization of clinical care,and standardized management of antifungal therapy duration to improve patient outcomes.

Abstract:Objective To explore the related influencing factors of secondary fungal infection in hemodialysis(HD)patients with deep venous catheterization and to construct a prediction model.Methods From January 2020 to June 2024,31 patients with fungal infection secondary to deep vein catheterization HD in the blood purification center of the Department of Nephrology,the First Affiliated Hospital of Air Force Medical University were included as the experimental group,and 93 patients who received deep vein catheterization HD at the same time were randomly selected as the control group according to the ratio of 1∶3.The clinical data of the two groups were collected.Logistic regression was used to analyze the risk factors of fungal infection secondary to deep vein catheterization HD.The receiver operating characteristic curve(ROC)was constructed by the probability value fitted by the regression equation.Results Among the 31 patients with fungal infection secondary to deep venous catheterization HD,31 strains of fungi were isolated and cultured,mainly Candida albicans and Aspergillus fumigatus,accounting for 41.94%and 16.13%,respectively.Multivariate logistic regression showed that age(OR=1.167),diabetes(OR=0.114),APACHE Ⅱ score(OR=1.378),catheter indwelling time(OR=1.870),and antibiotic use time(OR=1.346)were independent risk factors for fungal infection secondary to deep vein catheterization HD(P＜0.05).ALB(OR=0.882)was a protective factor for fungal infection secondary to deep vein catheterization HD(P＜0.05).ROC analysis showed that there were statistically significant differences in age,diabetes,APACHE Ⅱ score,catheter indwelling time,antibiotic use time,ALB and combined prediction of fungal infection secondary to deep venous catheterization HD(P＜0.05).Among them,AUC=0.953,95%CI was 0.918-0.989,sensitivity was 0.871,specificity was 0.914,and the predictive value was high.Conclusion Advanced age,diabetes,high APACHE Ⅱ score,long-term catheter indwelling,and antibiotic use time are independent risk factors for fungal infection secondary to deep vein catheterization HD,and ALB is its protective factor.Therefore,precise preventive measures should be implemented for the above factors.

Abstract:Objective To analyze the epidemiological characteristics,drug resistance and prognostic factors of Candida auris infection in a hospital in Guangzhou.Methods A total of 103 inpatients with MALDI-TOF MS-confirmed C.auris infections from January 2023 to February 2025 were retrospectively enrolled.Clinical data were collected through the hospital information system.Antifungal susceptibility testing was performed using the ATB FUNGUS 3 kit with a standardized microbroth dilution method.Multivariate logistic regression analysis was conducted to identify the prognostic factors.Results A total of 113 strains of C.auris were isolated,and the isolation rate in 2024(0.53%)increased significantly by 196.00%compared with that in 2023(0.18%).Most of the isolates were from clean middle urine(67.26%),and the intensive care unit was the high-risk department(27.43%).Drug sensitivity results showed that fluconazole had the highest resistance rate(72.57%).Isolates were sensitive to amphotericin B(96.46%)and 5-fluorocytosine(84.07%).Multi-drug resistant strains accounted for 26.55%.Multivariate analysis showed that surgical intervention(OR=0.227,P=0.011)and β-lactam antibiotics(non-carbapenem)use(OR=0.209,P=0.033)were independent protective factors for prognosis.Conclusions C.auris infection spreads rapidly,and azole drug resistance is a prominent problem.It is necessary to strengthen the infection control in key departments and the rational application of antifungal drugs.Surgical intervention and precise use of β-lactam antibiotics may improve the prognosis of patients,and further multicenter studies are needed to explore the mechanism.