| Abstract: | Objective This study aimed to evaluate the epidemiological, clinical and mycological characteristics of invasive candidiasis (IC) in China. Methods A ten-year retrospective study including 183 IC episodes was conducted in a tertiary hospital in Beijing, China. Results The overall incidence of IC from 2010–2019 was 0.261 episodes per 1,000 discharges. Candidemia (71.0％) was the major infective pattern; 70.3％ of the patients tested positive for Candida spp. colonization before IC and the median time to develop an invasive infection after colonization was 13.5 days (interquartile range: 4.5–37.0 days). Candida albicans (45.8％) was the most prevalent species, followed by Candida parapsilosis (19.5％), Candida glabrata (14.2％) and Candida tropicalis (13.7％). C. non-albicans IC was more common in patients with severe anemia (P = 0.018), long-term hospitalization (P = 0.015), hematologic malignancies (P = 0.002), continuous administration of broad-spectrum antibiotics (P < 0.001) and mechanical ventilation (P = 0.012). In vitro resistance testing showed that 11.0％ of the Candida isolates were resistant/non-wild type (non-WT) to fluconazole, followed by voriconazole (9.6％), micafungin (3.8％), and caspofungin (2.9％). Fluconazole was the most commonly used drug to initiate antifungal therapy both before and after the proven diagnosis (52.6％ and 54.6％, respectively). The 30-day and 90-day all-cause mortality rates were 24.5％ and 32.7％, respectively. Conclusion The incidence of IC has declined in the recent five years. C. non-albicans contributed to more than half of the IC cases. Fluconazole can be used as first-line therapy if resistant strains are not prevalent. Prospective, multi-center surveillance of the clinical and mycological characteristics of IC is required. |
