Background

Candida bloodstream infection (CBSI) is a growing problem among patients with cancer.

Aim

To describe the main clinical and microbiological characteristics in patients with cancer who suffer CBSI.

Methods

We reviewed the clinical and microbiological characteristics of all patients with CBSI diagnosed between January 2010 and December 2020, at a tertiary-care oncological hospital. Analysis was done according to the Candida species found. Multivariate logistic regression analysis was used to determine the risk factors associated with 30-day mortality.

Results

There were 147 CBSIs diagnosed, 78 (53%) in patients with hematologic malignancies. The main Candida species identified were Candida albicans (n = 54), Candida glabrata (n = 40) and Candida tropicalis (n = 29). C. tropicalis had been mainly isolated from patients with hematologic malignancies (79.3%) who had received chemotherapy recently (82.8%), and in patients with severe neutropenia (79.3%). Seventy-five (51%) patients died within the first 30 days, and the multivariate analysis showed the following risk factors: severe neutropenia, a Karnofsky Performance Scale score under 70, septic shock, and not receiving appropriate antifungal treatment.

Conclusions

Patients with cancer who develop CBSI had a high mortality related with factors associated with their malignancy. Starting an empirical antifungal therapy the soonest is essential to increase the survival in these patients.

中文翻译：

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癌症患者的念珠菌血流感染：11 年的回顾性分析

背景

念珠菌血流感染 (CBSI) 是癌症患者中日益严重的问题。

目的

描述患有 CBSI 的癌症患者的主要临床和微生物学特征。

方法

我们回顾了 2010 年 1 月至 2020 年 12 月期间在一家三级肿瘤医院诊断出的所有 CBSI 患者的临床和微生物学特征。根据发现的念珠菌种类进行分析。多变量逻辑回归分析用于确定与 30 天死亡率相关的危险因素。

结果

诊断出 147 例 CBSI，其中 78 例 (53%) 为血液系统恶性肿瘤患者。确定的主要念珠菌属是白色念珠菌( n  =  54)、光滑念珠菌( n  =  40) 和热带念珠菌( n  =  29)。热带念珠菌主要分离自最近接受过化疗的血液系统恶性肿瘤患者 (79.3%) (82.8%) 和重度中性粒细胞减少症患者 (79.3%)。75 名 (51%) 患者在前 30 天内死亡，多变量分析显示以下风险因素：严重的中性粒细胞减少症、Karnofsky 性能量表评分低于 70、感染性休克和未接受适当的抗真菌治疗。

结论

发生 CBSI 的癌症患者的死亡率很高，这与其恶性肿瘤相关的因素有关。尽快开始经验性抗真菌治疗对于提高这些患者的存活率至关重要。