A study on clinical features and prognostic risk factors of candidemia cases

CHEN Mingxia; ZHANG Xin; MA Qian; NI Ping

doi:10.3969/j.issn.1673-3827.2026.01.008

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.