ArticleBMC infectious diseases2026
Epidemiology, risk factors, and mortality of Candida bloodstream infection in Yulin, China: a 7-year retrospective study.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCandida bloodstream infection (BSI) causes substantial morbidity and mortality in hospitalized patients, and its epidemiology may vary across resource-limited settings. We described Candida species distribution in candidemia patients in Yulin, China, and assessed factors associated with species patterns and predictors of 28-day mortality to support risk stratification and clinical management.
methodsWe retrospectively included patients with a first episode of candidemia at The First People’s Hospital of Yulin (2018–2024), collecting demographic, clinical, laboratory, and treatment data. Factors associated with C. albicans (vs non-albicans) candidemia were evaluated using univariate tests and multivariable logistic regression, and predictors of 28-day mortality were assessed with Cox models and Kaplan–Meier analyses.
resultsA total of 565 patients were included; 64.1% were male, and the median age was 65 years (IQR, 55–73). C. albicans was the most common species (45.7%, 258/565), while non-albicans Candida accounted for 54.3%, mainly C. glabrata (16.6%), C. tropicalis (16.5%), and the C. parapsilosis complex (15.0%). From 2018 to 2024, the overall number of isolates increased, with a progressive shift toward non-albicans Candida species. Mechanical ventilation was an independent risk factor for C. albicans BSI (OR = 1.748, 95% CI 1.225–2.495). The 28-day mortality rate was 21.9% (124/565). Independent risk factors for 28-day mortality included solid organ malignancy (aHR = 2.429, 95% CI 1.435–4.111), coronary heart disease (aHR = 1.610, 95% CI 1.079–2.403), digestive system diseases (aHR = 1.510, 95% CI 1.048–2.176), clavicular vein catheterization (aHR = 1.666, 95% CI 1.082–2.566), mechanical ventilation (aHR = 2.080, 95% CI 1.297–3.334), and hemodialysis (aHR = 1.724, 95% CI 1.168–2.546). Patients who received antifungal therapy showed higher observed survival than those who did not (log-rank p < 0.001), whereas patients with central venous catheterization showed lower observed survival than those without (log-rank p = 0.009).
conclusionsCandidemia in Yulin was mainly caused by C. albicans, with a rising contribution from non-albicans species. Mechanical ventilation was associated with C. albicans candidemia, and gastrointestinal diseases, mechanical ventilation, and hemodialysis were linked to higher 28-day mortality. Enhanced risk-based surveillance and timely guideline-concordant management may improve outcomes, but prospective studies are needed to confirm these findings.
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