BackgroundCandida species are among the most important invasive pathogens in intensive care units (ICUs). Non‐albicans species including Candida parapsilosis (C. parapsilosis) has increased in recent years. Fluconazole is the leading antifungal agent but resistance is a concern among C. parapsilosis species.ObjectivesThe aim of this study was to determine the factors associated with fluconazole resistance in patients with candidemia due to C. parapsilosis in ICUs.MethodsThis case–case study was conducted in a 750‐bed, tertiary hospital between 2015 and 2021. Patients with fluconazole‐resistant C. parapsilosis candidemia constituted the ‘cases of interest’ group and patients with fluconazole‐susceptible C. parapsilosis candidemia constituted the ‘comparison cases’ group. Demographic and clinical data of the patients were recorded. Logistic regression analysis was performed using the backward elimination method to determine the independent predictors of fluconazole‐resistant C. parapsilosis bloodstream infections.ResultsThe study included 177 patients. In the cultures of these patients, 76 (43%) fluconazole‐resistant, 13 (7.3%) fluconazole‐reduced susceptible, and 88 (49.7%) fluconazole‐susceptible isolates were found. In the regression analysis the risk factors for fluconazole‐resistant C. parapsilosis bloodstream infection, malignancy, immunosuppressive treatment, history of intra‐abdominal surgery, hypoalbunemia, previous fluconazole use, and SOFA score were found to be associated in univariate analysis. In multivariate regression analysis, history of intra‐abdominal surgery (OR: 2.16; 95% CI: 1.05–4.44), hypoalbuminemia (OR: 2.56; 95% CI: 1.06–6.17) and previous fluconazole use (OR: 3.35; 95% CI: 1.02–11) were found to be independent predictors.ConclusionsIn this study, a significant correlation was found between candidemia due to fluconazole‐resistant C. parapsilosis in ICUs and intra‐abdominal surgery, hypoalbuminemia, and previous fluconazole use. C. parapsilosis isolates and fluconazole resistance should be continuously monitored, strict infection control measures should be taken and antifungal stewardship programs should be implemented.

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与近平滑念珠菌念珠菌血症氟康唑耐药相关的危险因素：病例研究

背景念珠菌属是重症监护病房 (ICU) 中最重要的入侵病原体之一。非白色念珠菌属物种包括近光滑念珠菌（近平滑念珠菌）近年来有所增加。氟康唑是主要的抗真菌药物，但耐药性是人们关注的问题近平滑念珠菌目的本研究的目的是确定与念珠菌血症患者氟康唑耐药相关的因素近平滑念珠菌方法本病例研究于 2015 年至 2021 年间在一家拥有 750 个床位的三级医院进行。近平滑念珠菌念珠菌血症构成“感兴趣的病例”组和氟康唑敏感患者近平滑念珠菌念珠菌血症构成“比较病例”组。记录患者的人口统计学和临床​​数据。使用向后消除法进行逻辑回归分析以确定氟康唑耐药的独立预测因素近平滑念珠菌血流感染。结果该研究包括 177 名患者。在这些患者的培养物中，发现了 76 株（43%）氟康唑耐药菌株、13 株（7.3%）氟康唑减感菌株和 88 株（49.7%）氟康唑敏感菌株。回归分析显示氟康唑耐药的危险因素近平滑念珠菌单变量分析发现血流感染、恶性肿瘤、免疫抑制治疗、腹腔内手术史、低蛋白血症、既往氟康唑使用情况和 SOFA 评分相关。在多变量回归分析中，腹部手术史（OR：2.16；95% CI：1.05-4.44）、低蛋白血症（OR：2.56；95% CI：1.06-6.17）和既往使用过氟康唑（OR：3.35；95%） CI：1.02-11）被发现是独立的预测因素。结论在这项研究中，发现氟康唑耐药引起的念珠菌血症之间存在显着相关性近平滑念珠菌在 ICU 和腹腔内手术中、低蛋白血症和既往使用氟康唑。近平滑念珠菌应持续监测分离株和氟康唑耐药性，采取严格的感染控制措施并实施抗真菌管理计划。