Clinical features and prognosis of elderly patients with candidemia

Abstract:

Objective：To analyze clinical features and prognosis of elderly patients with candidemia，and to provide basis for clinical diagnosis and treatment of candidemia. Methods：A total of 165 cases of candidemia diagnosed in a hospital were collected from January 2015 to December 2018，including the basic data，treatment records，outcomes，and laboratory reports. According to the hospital stay，the patients were divided into two groups：the first group（104 cases） was no more than 28 d，the second（61 cases） was over 28d. Results：Candida isolated from blood culture of 165 cases were mainly Candida albicans（78 cases），Candida parapsilosis （40 cases），and Candida tropicalis（40 cases），which were mainly distributed in ICU（82 cases），internal medicine（25 cases），and surgery（18 cases）. All patients were accompanied by other diseases in different degrees with a mortality of 54.5%. The mortality of the second group was higher than that of the first group（P<0.05），and the mortality of the cases without antifungal drugs was higher than the cases with antifungal drugs（P<0.05）. In addition，WBC，PCT，（1，3）-β-D-glucan and IL-6 were increased in varying degrees，however，there were no specificity for the early diagnosis of candidemia. Conclusion：The clinical features of candidemia is not obvious and the prognosis of patients is seriously affected. Clinicians should put a high value on candidemia and improve the routine inspection of blood culture. Antimicrobial agents should be used rationally，in order that early diagnosis and treatment of candidemia can be achieved and the prognosis of patients can be improved effectively.