Clinical characteristics,drug resistance and prognostic analysis of invasive candidiasis in ICU patients

ZHOU Haichun; ZOU Xingyu; WANG Junwen; GUO Yunyun

doi:10.3969/j.issn.1673-3827.2025.01.007

Abstract：Objective To investigate the clinical characteristics,drug resistance,and prognostic analysis of invasive candidiasis(IC)in intensive care unit(ICU)patients.Methods A retrospective analysis was conducted on 356 patients with persistent fever admitted to the ICU of our hospital from October 2020 to September 2024.Patients were divided into two groups based on whether they developed IC:the IC group(n=89)and the non-IC group(n=267).The distribution of Candida species and their drug resistance were statistically analyzed,as well as the outcomes and clinical endpoints of the two groups.Results Among the 89 cases in the IC group,97 strains of Candida were identified,with the highest proportion being C.albicans(44 strains,45.36%),and the most common specimen for fungal isolation was urine.Among the 97 strains of Candida underwent susceptibility testing,C.tropicalis showed the most severe drug resistance(46.15%),with the highest overall resistance to itraconazole(18 strains,18.56%),and the lowest resistance to caspofungin(0.00%).The duration of ICU stay and mechanical ventilation use in the IC group were significantly higher than those in the non-IC group(P<0.05),and the difference in the activity of daily living(ADL)scores at admission and discharge from the ICU was significantly higher in the IC group(P<0.05);the survival rate was significantly lower in the IC group(P<0.05).Pearson correlation analysis showed that IC in ICU patients was significantly positively correlated with the duration of ICU stay and mechanical ventilation use(P<0.05),and significantly negatively correlated with the difference in ADL scores(P<0.05).Conclusion In ICU patients who developed secondary IC,C.albicans was the most frequently isolated fungus,and urine was the specimen with the highest detection rate of fungal strains.C.tropicalis showed the highest antifungal resistance,with the highest resistance to itraconazole,and the best sensitivity to caspofungin.The prognosis and clinical outcomes of ICU patients with secondary IC were relatively poorer.