Evolving Epidemiology of Invasive Candidiasis in Southwest China: A Four-year Analysis of Species Distribution, Antifungal Resistance Profiles, and Mortality Risk Factors
- 1Department of Clinical Laboratory Medicine
- 2Department of Laboratory Medicine and Sichuan Provincial Key Laboratory for Human Disease Gene Study
Abstract
Xiaoyan Feng,1,* Jun Li,2,* Shuang Li,1 Lili Yang,1 Ke Li11Department of Clinical Laboratory Medicine, The Third People’s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, People’s Republic of China; 2Department of Laboratory Medicine and Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ke Li, Department of Clinical Laboratory Medicine, The Third People’s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, No. 82 Qinglong Street, Qingyang District, Chengdu, Sichuan, 610031, People’s Republic of China, Tel: +86 028-61318622, Email [email protected] Lili Yang, Department of Clinical Laboratory Medicine, The Third People’s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, No. 82 Qinglong Street, Qingyang District, Chengdu, Sichuan, 610031, People’s Republic of China, Tel: +86 028-61318622, Email [email protected]: The purpose of this study was to explore the strain distribution, clinical characteristics, antifungal sensitivity and risk factors of 30-day mortality of invasive Candida infection of hospitalized patients.Patients and Methods: We conducted a four-year retrospective study at a tertiary teaching hospital in Southwest China, enrolling non-duplicate strains isolated from invasive candidiasis samples obtained from hospitalized patients.Results: Of the 345 non-duplicate invasive candidiasis cases, 145 (42%) were candidemia cases. Candida albicans (44.3%) was the most identified species, followed by C. glabrata (18.2%), C. tropicalis (14.5%), and C. parapsilosis (12.5%). Amphotericin B and echinocandins demonstrated potent in vitro activity, whereas Candida species exhibited high resistance rates to azole antifungals, particularly C. tropicalis, whose resistance rate approaches 30%. Compared to patients in general wards, ICU patients exhibited more severe clinical symptoms, higher rates of invasive medical procedures and antibiotic exposure. Multivariate analysis identified hepatobiliary disease, surgical interventions within 6 months, tracheal intubation, ICU admission, and use of aminoglycosides and tetracyclines as independent risk factors for 30-day mortality. Additionally, the study revealed that elevated levels of BDG, and IL-6, as well as reduced PLT, were associated with increased 30-day mortality.Conclusion: A better understanding of the specific risk factors associated with ICU stays could facilitate earlier identification of high-risk candidates for antifungal therapy initiation, thereby improving clinical outcomes for critically ill patients with invasive candidiasis.Keywords: invasive candidiasis, strain distribution, antifungal drug susceptibility, risk factors
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BibTeX
@article{feng2026evolving,
title = {{Evolving Epidemiology of Invasive Candidiasis in Southwest China: A Four-year Analysis of Species Distribution, Antifungal Resistance Profiles, and Mortality Risk Factors}},
author = {Feng X and Li J and Li S and Yang L and Li K},
journal = {Infection and Drug Resistance},
year = {2026},
month = nov,
url = {https://www.dovepress.com/evolving-epidemiology-of-invasive-candidiasis-in-southwest-china-a-fou-peer-reviewed-fulltext-article-IDR},
note = {CC BY},
}
RIS
TY - JOUR
TI - Evolving Epidemiology of Invasive Candidiasis in Southwest China: A Four-year Analysis of Species Distribution, Antifungal Resistance Profiles, and Mortality Risk Factors
AU - Feng X
AU - Li J
AU - Li S
AU - Yang L
AU - Li K
PY - 2026
DA - 2026/11/05
JO - Infection and Drug Resistance
UR - https://www.dovepress.com/evolving-epidemiology-of-invasive-candidiasis-in-southwest-china-a-fou-peer-reviewed-fulltext-article-IDR
AB - Xiaoyan Feng,1,* Jun Li,2,* Shuang Li,1 Lili Yang,1 Ke Li11Department of Clinical Laboratory Medicine, The Third People’s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, People’s Republic of China; 2Department of Laboratory Medicine and Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ke Li, Department of Clinical Laboratory Medicine, The Third People’s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, No. 82 Qinglong Street, Qingyang District, Chengdu, Sichuan, 610031, People’s Republic of China, Tel: +86 028-61318622, Email [email protected] Lili Yang, Department of Clinical Laboratory Medicine, The Third People’s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, No. 82 Qinglong Street, Qingyang District, Chengdu, Sichuan, 610031, People’s Republic of China, Tel: +86 028-61318622, Email [email protected]: The purpose of this study was to explore the strain distribution, clinical characteristics, antifungal sensitivity and risk factors of 30-day mortality of invasive Candida infection of hospitalized patients.Patients and Methods: We conducted a four-year retrospective study at a tertiary teaching hospital in Southwest China, enrolling non-duplicate strains isolated from invasive candidiasis samples obtained from hospitalized patients.Results: Of the 345 non-duplicate invasive candidiasis cases, 145 (42%) were candidemia cases. Candida albicans (44.3%) was the most identified species, followed by C. glabrata (18.2%), C. tropicalis (14.5%), and C. parapsilosis (12.5%). Amphotericin B and echinocandins demonstrated potent in vitro activity, whereas Candida species exhibited high resistance rates to azole antifungals, particularly C. tropicalis, whose resistance rate approaches 30%. Compared to patients in general wards, ICU patients exhibited more severe clinical symptoms, higher rates of invasive medical procedures and antibiotic exposure. Multivariate analysis identified hepatobiliary disease, surgical interventions within 6 months, tracheal intubation, ICU admission, and use of aminoglycosides and tetracyclines as independent risk factors for 30-day mortality. Additionally, the study revealed that elevated levels of BDG, and IL-6, as well as reduced PLT, were associated with increased 30-day mortality.Conclusion: A better understanding of the specific risk factors associated with ICU stays could facilitate earlier identification of high-risk candidates for antifungal therapy initiation, thereby improving clinical outcomes for critically ill patients with invasive candidiasis.Keywords: invasive candidiasis, strain distribution, antifungal drug susceptibility, risk factors
SN - 1178-6973
ER -