Clinical Implications, Risk Factors And Predictors with Mixed Candida/bacterial Bloodstream Infection (BSI), Especially in Cadiovascular Patients

Abstract

Abstract Background. To identify the clinical implications, risk factors and predictors with mixed candida/bacterial bloodstream infection (BSI) of cadiovascular patients in Guangdong Provincial People’s Hospital, Guangzhou, Guangdong, China (a third-class hospital with a strong focus on cardiovascular disease). We conducted a retrospective case-control study of patients complicated with candidaemia over the past 10-year period to identify the risk factors and clinical implications of mixed candidia/bacterial BSIs vs. monobacterial candidiasis. Method. We searched all discharged patients' diagnoses for icd codes related to candida bloodstream infection. We have made two sets of comparisons:1. Two groups of patients were compared: all cadiovascular patients with mixed candida/bacterial BSI (cases1 n=86), and all no cadiovascular patients with mixed candida/bacterial BSI (control 2 n=45); 2. Two groups of patients were compared: all patients with mixed candida/bacterial BSI (cases1 n=69), and all patients with mono candida BSI (control 2 n=62). Statistical analysis was performed using SPSS 25.0 statistical software. The independent sample t-test and chi-square analysis was used. Result. The median age of the patients who have mixed candida / bacterial BSI was 63 years old, and 70.42% of these patients were male. Cardiovascular disease was the most common underlying disease of mixed candida / bacterial BSI, followed by neurological disease, and followed by tumors and diabetes. In cases of mono candida bloodstream infection, infection with Candida tropicalis and Candida albicans dominated. In cases of mixed bloodstream infection with bacterial candida, the highest proportion is Candida albicans. In the cases of candida bloodstream infection without cardiovascular underlying disease, it is Candida tropicalis, followed by Candida albicans. Opposite, in the cases with an underlying cardiovascular disease, the highest proportion is Candida albicans. Conclusion. Our data show that older adults（age＞65 years）, men are more susceptible to candida bloodstream infections. Bacterial candida mixed bloodstream infections mostly led by staphylococcus sp. Procalcitonin（PCT）, white blood cell（WBC）, neutrophilicgranulocyte（N） were predictive for mixed bloodstream infection with bacterial candida species. Among the cases in our hospital, patients with underlying cardiovascular disease were associated with mixed bacterial candida infections.