Analysis of the clinical characteristics and treatment of candidemia caused by different pathogens

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Methods A retrospective study was conducted with a focus on patients who had a clear diagnosis of "candidiasis" in our hospital from January 2020 to July 2023. The demographic data, past history, vital signs at onset, laboratory examination, treatment plan and prognosis were collected and analyzed. Results There was no significant difference in the age of onset or mortality of patients in the different pathogen groups (F 1 = 0.26,P 1 = 0.85;F 2 = 3.31, P 2 = 0.34) .Broad-spectrum antibiotic use, BMI, albumin, parenteral nutrition support, history of gastrointestinal surgery, history of urinary tract surgery and history of G + coccidiosis infection were risk factors for death in patients with candidemia. WBC counts in the C. albicans and C. tropicalis groups were significantly greater (F = 3.95, P = 0.01) than those in the other groups. The C. tropicalis group had higher serum creatinine levels and shorter TTD (F 1 = 8.40, P 1 = 0.03; F 2 = 5.03, P 2 < 0.01).The efficacy of triazoles was similar to that of echinocandins (χ 2 = 0.05, P = 0.81). After comparing the efficacy of triazoles and echinocandins across the four of pathogen groups, no measurable difference was detected (χ 1 2 = 1.20, P 1 = 0.75; χ 2 2 = 0.05, P 2 = 0.81) . Conclusion In addition to common risk factors such as older age and hypoproteinemia, a history of gastrointestinal and urinary surgery, a history of broad-spectrum antibiotic use, long-term parenteral nutrition support and G + coccyxaemia may also be risk factors for death due to candidemia. Echinocandins are recommended as first-line treatments. Candidemia β-D-glucan triazoles echinocandins 1. Background Candidemia, which is an opportunistic infection, ranks third among the major bloodstream infectious diseases that threaten public health, and its highest case rate reaches 2.23/10000. The increasing incidence of this disease leads to longer hospital stays and higher mortality rates. 1 – 5 2. Materials and Methods 2.1 Clinical Data A retrospective study was conducted with a focus on patients who had a clear diagnosis of "candidiasis" in our hospital from January 2020 to July 2023. A total of 94 patients, including 54 male patients and 31 female patients, were enrolled in this study according to the following criteria: 1) age older than 18 years, 2) complete clinical data and 3) a single bacterial infection according to blood culture; at least one Candida strain was cultured after excluding the possibility of contamination considering the definition of candidemia, and these blood cultures revealed unequivocal Candida infection 6 – 7 . The exclusion criteria were as follows: 1) voluntary waiving of treatment halfway through the hospital stay; 2) blood culture demonstrated Candida infection that was likely caused by contamination; 3) 2 or more Candida infections according to blood culture; and 4) simultaneous bacterial bacteremia. This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Beijing Tsinghua Changgung Hospital affiliated with Tsinghua University. 2.2 Research and Statistical Methods The demographic data of the patients (sex, age, etc.), past history, vital signs at onset, laboratory examination, treatment plan and prognosis were collected in this study. Negative results of Candida blood culture after 7 days of treatment was considered to indicate treatment efficacy. Statistical analysis was performed with SPSS 25.0 software. Count data are expressed as the percentage of the number of patients, and cross-tab was used for multigroup comparisons. Normally distributed data are expressed as (x ± s), and t tests were used for comparisons of two groups of data. ANOVA was used for comparisons of the average values of multiple groups of data. Nonnormally distributed data are expressed as M (P 25 , P 75 ), and a nonparametric test was used to analyze data among multiple groups. Logistic regression analysis was used to analyze the relationships between the observed indicators and patient prognosis. Survival analysis was used to determine the relationships between different group indicators and patient mortality. When P < 0.05, the difference was considered clinically significant. 3. Research Results A total of 94 patients, including 59 males and 35 females, were enrolled in this study. The average age at onset was 66.36 ± 13.88 years, with 66.15 ± 2.69 years being the age of onset in males and 66.55 ± 3.19 years being the age of onset in females. No significant difference was observed between these groups (t=-0.09, P = 0.92). In this study, 22 patients (23.40%) died. Candida albicans ( C. albicans ) accounted for 46.8% of the cases, Candidia parapsilosis ( C. parapsilosis ) accounted for 23.4% of the cases, Candidia glabrata ( C. glabrata ) accounted for 17.0% of the cases, and Candida tropicalis ( C. tropicalis ) accounted for 12.8% of the cases (44 vs. 22 vs. 16 vs. 12). There was no significant difference in the age of onset or mortality of patients in the different pathogen groups (F 1 = 0.26, P 1 = 0.85; F 2 = 3.31, P 2 = 0.34) (Table 1 ). In addition, during the process of data collection, we found that 30 patients (31.91%) had gram-positive (G + ) coccidiosis within 10 days (Table 1 ). Table 1 Basic issues in different group Items C. albicans C. parapsilosis C. glabrata C. tropicalis Overall Result(χ 2 /F) P Number 44 22 16 12 94 - - Male 31(70.45) 15(68.18) 7(43.75) 6(50.00) 59(62.76) 4.70 0.19 Age(years old) (66.61 ± 1.89) (66.68 ± 2.61) (63.68 ± 4.26) (68.08 ± 5.11) (66.31 ± 13.88) 0.26 0.85 History of Tumor 18(40.91) 8(36.36) 5(31.25) 6(50.00) 37 1.13 0.76 Billary surgery 1 12(20.27) 2(9.09) 2(12.50) 4(33.33) 18 5.19 0.15 Gastrointestinal surgery 1 14(31.81) 9(40.91) 10(62.50) 3(25.00) 36 5.70 0.12 PN 1 25(56.81) 11(50.00) 10(62.50) 4(33.33) 50 2.78 0.42 Broad-spectrum antibiotic use 1 27(61.36) 10(45.45) 10(62.50) 3(25.50) 50 6.09 0.10 Urinary tract surgery 1 4(9.09) 2(9.09) 2(12.50) 2(16.67) 10 0.68 0.87 Chemotherapy 1 3(6.81) 1(4.54) 1(6.25) 1(8.33) 6 0.21 0.97 Diabetes 6(13.63) 9(40.91) 3(18.75) 1(8.33) 19 8.09 0.04 COPD 2(4.54) 1(4.54) 1(6.25) 3(25.00) 7 6.20 0.10 Heart disease 3(6.81) 5(22.72) 1(6.25) 1(8.33) 10 4.44 0.21 CKD 2(4.54) 1(4.54) 2(12.50) 1(8.33) 6 1.45 0.69 Mental disease 4(9.09) 2(9.09) 1(6.25) 1(8.33) 8 0.13 0.98 Cirhosis 4(9.09) 1(4.54) 1(6.25) 1(8.33) 7 0.48 0.92 Immune disease 2 1(2.27) 0(0.00) 0(0.00) 1(8.33) 2 - - G + coccidiosis infection 12(27.27) 9(40.91) 5(31.25) 4(33.33) 30 1.27 0.73 Death 10(22.73) 5(22.72) 2(12.50) 5(41.67) 22 3.31 0.34 1.History of billary surgery,gastrointestinal surgery,broad-spectrum antibiotic use,urinary tract surgery,Chemotherapy and parenteral nutrition support(PN) in these two weeks. Broad-spectrum antibiotic use, Body mass index(BMI), albumin(ALB), parenteral nutrition(PN) support, history of gastrointestinal surgery, history of urinary tract surgery and history of G + coccidiosis infection were risk factors for death in patients with candidemia (Table 2 ). The longer the duration of parenteral nutrition was, the higher mortality rate (10.57, 95% OR 0.45–0.82, P < 0.01). In terms of recent broad-spectrum antibiotic use, patients were divided into a low-level antibiotic group (third-generation cephalosporins, quinolones, etc.) and a high-level antibiotic group (enzyme inhibitors, carbapenems, etc.). The level of antibiotics use, the duration of antibiotic treatment and the mortality rate were positively correlated (Coefficient of correlation:0.91,P < 0.01). Table 2 Logistic of death in different issues Items Wals 95% OR P Broad-spectrum antibiotic use 7.27 0.01ཞ1.54 < 0.01 BMI 7.92 1.10ཞ1.93 < 0.01 ALB 6.10 0.93ཞ1.32 0.04 PN 5.27 0.17ཞ29.99 0.02 Gastrointestinal surgery 2.94 0.10ཞ25.63 0.04 Urinary tract surgery 4.41 0.20ཞ39.71 0.03 G + coccidiosis infection 3.41 0.04ཞ1.09 0.04 Age 6.31 0.86ཞ0.98 0.01 Fever was the main symptom among the clinical manifestations, while the mean arterial pressure(MAP) was normal at the time of onset, and there was no difference in terms of different pathogens (Table 3 ). According to laboratory data, the inflammatory indexes C-reactive prtein (CRP)and Procalcitonin (PCT) were increased, while the lymphocyte count and the serum ALB and hemoglobin(HB)levels were decreased. White blood cell(WBC) counts in the C. albicans and C. tropicalis groups were significantly greater (F = 3.95, P = 0.01) than those in the other groups. Moreover, the C. tropicalis group had higher serum creatinine levels and shorter time to positivity(TTD) (F 1 = 8.40, P 1 = 0.03; F 2 = 5.03, P 2 < 0.01). There were no significant differences in age, BMI, body temperature or MAP, PCT, CRP, WBC, HB, platemet(PLT), lymphocyte, transaminase(AST), or ALB levels among the different pathogen groups. Table 3 Clinical presentation and laboratory results in differents groups Items C. albicans C. parapsilosis C. glabrata C. tropicalis Overall Result(F/H) P BMI(kg/m 2 ) (22.62 ± 0.52) (22.00 ± 0.67) (20.84 ± 0.95) (20.79 ± 0.74) (21.92 ± 0.34) 1.63 0.18 T( o C) (38.22 ± 0.15) (37.95 ± 0.20) (37.92 ± 0.21) (37.93 ± 0.12) (38.07 ± 0.09) 0.89 0.45 MAP(mmHg) (106.40 ± 2.32) (105.68 ± 2.79) (102.62 ± 3.29) (107.16 ± 5.03) (105.93 ± 1.46) 0.37 0.77 WBC(10 9 /L) (10.47 ± 0.72) (6.92 ± 0.99) (7.76 ± 0.71) (11.90 ± 2.88) (9.30 ± 0.53) 3.95 0.01 N(U/L) (9.27 ± 0.78) (4.68 ± 0.86) (5.52 ± 0.62) (11.38 ± 0.29) (7.77 ± 0.61) 5.70 0.01 Y(U/L) (0.69 ± 0.06) (0.94 ± 0.12) (0.68 ± 0.13) (0.79 ± 0.11) (0.76 ± 0.05) 1.25 0.29 HB(g/L) (95.40 ± 2.91) (97.81 ± 3.41) (88.68 ± 5.71) (88.16 ± 5.86) (94.03 ± 1.96) 1.20 0.31 PLT(10 12 /l) (144.89 ± 16.48) (192.90 ± 23.79) (148.31 ± 21.69) (140.50 ± 29.47) (140.50 ± 19.22) 0.37 0.77 PCT(ng/L) (0.41,2.89) (0.32,3.02) (0.27,1.65) (0.46,4.53) (0.35,2.76) 3.95 0.26 CRP(mg/L) (44.75,131.00) (24.25,84.00) (29.50,80.80) (13.75,152.75) (27.50,113.50) 2.35 0.50 AST(U/L) (20.75,72.20) (24.12,67.25) (26.12,46.75) (16.50,79.87) (21.55,61.85) 0.14 0.98 CRE(mmol/L) (46.22,102.75) (47.75,126.50) (49.25,159.00) (94.25,206.00) (50.25,143.50) 8.40 0.03 ALB(g/L) (30.75 ± 0.71) (31.29 ± 1.07) (29.35 ± 1.35) (28.83 ± 1.27) (30.35 ± 0.49) 0.98 0.40 TTD(hour) (45.16 ± 3.34) (33.18 ± 3.82) (39.56 ± 5.04) (22.16 ± 3.80) (38.44 ± 2.14) 5.03 < 0.01 In this study, 74 patients completed β-D-glucan(BDG) examination, but the percentage of patients with positive results was only 68.91% (49 vs. 25) (Table 3 ). Triazole, echinocandins and amphotericin B (54 vs. 37 vs. 3) were used as antifungal medicines in this study. Triazole, which contains fluconazole and voriconazole, was used to treat 57.45% of the patients, and fluconazole was the most commonly used medicine (35 vs. 19). Echinocandins, which mainly included carbafenine, was used to treat 39.36% of the patients. Seventy-one patients, including 1 patient treated with amphotericin B and 70 patients treated with triazoles and echinocandins, were asked to provide blood cultures after 7 days of treatment. The efficacy of triazoles was similar to that of echinocandins (χ 2 = 0.05, P = 0.81). After comparing the efficacy of triazoles and echinocandins across the four of pathogen groups, no measurable difference was detected (χ 1 2 = 1.20, P 1 = 0.75; χ 2 2 = 0.05, P 2 = 0.81) (Table 4 ). Table 4 Effective of different drugs treatment Triazoles Echinocandins Overall Effective Non-effective Effective Non-effective C. albicans 17 3 14 1 35 C. parapsilosis 4 2 7 2 15 C. glabrata 6 1 4 1 12 C. tropicalis 3 1 3 1 8 Overall 30 7 25 5 70 Overall:χ 2 =0.05, P = 0.81;Triazoles: χ 2 ༝1.20,P = 0.75;Echinocandins༚χ 2 ༝1.58, P = 0.66 4. Discussion Candidemia is a fatal disease that is difficult to diagnose in America and Europe. Candida albicans is the most common causative agent of this condition, accounting for 89.5% of candidemia cases. However, Candida albicans accounted for 46.8% of the cases identified in our study, which is less than that reported in other studies. Older age, immunosuppressive drug use (glucocorticoids, chemotherapeutic drugs, immunosuppressants, etc.), neutropenia, complete parenteral nutrition therapy, organ transplantation, renal insufficiency, tumor history, hypoproteinemia, anemia and severe sepsis are risk factors for candidemia. 6 – 11 Moreover, we found that a history of gastrointestinal surgery, a history of urinary tract surgery, a recent history of G + coccyxemia and broad-spectrum antibiotic use, especially high-level broad-spectrum antibiotic use, may also be risk factors for candidemia. There are several reasons for this. 1) Candida usually colonizes the gastrointestinal tract and urinary tract, while surgeries can cause the bacteria to transfer to other places. The high intestinal colonization rate of Candida albicans also increases the incidence of infection in patients who undergo gastrointestinal surgery. 2) High-level broad-spectrum antibiotic use easily causes intestinal and urinary tract flora imbalances in patients. 3) Postoperative patients have low immunity. 4) Increased parenteral nutrition in patients after gastrointestinal surgery exacerbates flora imbalances and shifts. Notably, 31.91% of patients had a history of G + coccusemia within 10 days before the onset of candidemia, among whom 40% were postoperative patients. G + coccusemia causes increased vascular permeability, accelerating the entry of Candida into the blood. In addition, severe bacteremia can cause immunosuppression, and high-level broad-spectrum antibiotics also contribute to candidemia. The detection of candidemia lacks specificity. Fever was the most common symptom that was observed in the present study. As in previous research, WBC and CRP levels increased slightly, while CRE, ALT, and AST levels were within normal limits. 9 – 12 The lymphocyte count was low overall, while there was no significant difference between the different pathogenic groups. The lymphocyte count is an indicator of cellular immunity and nutritional status. Low immunity, poor postoperative nutritional status, hypoproteinemia, anemia, and immunosuppression can all lead to low lymphocyte counts. In this study, 12 patients received antifungal treatment before BDG detection, which might be the main reason for the lower positivity rate. However, the etiological diagnosis cannot be determined in a short period. Similar to most studies, the median TTD in this study was 38.44 ± 2.14 hours, and the results were relatively limited. Therefore, most studies recommend BDG detection to help diagnose invasive candidiasis, especially candidemia, and this approach has a sensitivity of 87.1% and specificity of 96%. 7 , 13 – 15 We still recommend BDG detection as an important method for the diagnosis of candidemia. In addition, the Candida tropicalis group had more abnormal renal function, and the TTD was shorter (Table 3 ). The literature has pointed out that Candida tropicalis grows faster than other species, with a larger number of colonies in the blood, stronger antibiotic resistance and mucosal penetration and the ability to easily form biofilms with strong adhesion; these properties increase the invasion of this pathogen compared with that of other species. 16 – 17 Triazole, echinocandins, polyene, and 5-fluorouracil are commonly used antifungal drugs. In this study, except for 3 patients who were treated with amphotericin B, the other patients were treated with triazoles (including fluconazole and voriconazole) and echinocandins (carbofen). No difference in the effects of treatment with triazoles or echinocandins (χ 2 = 0.05, P = 0.81) was observed, and no difference was observed in the effects of treatments targeting different pathogenic bacteria. However, echinocandins are still recommended as a first-line treatment for several reasons. 1) Compared with fluconazole and echinocandins, there is no significant difference in the prognosis of treatment in terms of patient age, race, sex, past history, etc., but in terms of the readmission rate, the prognosis of patients treated with echinocandins is significantly lower than that of patients treated with fluconazole (P = 0.019) 16 .2) Compared with that of the Candida albicans group (MIC 50 , MIC 90 ), the carbafenacin group had MIC 50 and MIC 90 values of 0.03 and 0.12, and the fluconazole group had MIC 50 and MIC 90 values of 0.25 and 0.5; however, carbafenacin has a better antibacterial effect, and the blood culture became negative more quickly after treatment with carbafenacin 7 , 16 – 18 . 3) The resistance rate of echinocandins was relatively low, and there was no echinocandin resistance, while 3 patients exhibited triazole resistance in our study. Studies have shown that the rate of resistance to echinocandins is less than 0.1%, while that to triazole is 20% 4,17 . 4) Compared with echinocandins, fluconazole is more likely to cause liver injury 17 – 21 . 5) Most patients with candidiasis have serious symptoms, and echinocandins are used as first-line medicine while adopting the "down-the-ladder" anti-infection approach. 5. Limitations 1) As this was a retrospective study and single-center study, the amount of data was relatively small, and possible sampling bias could exist. 2) The sources of the patients were unified, and the evaluation of disease severity was deficient. The APACHE II score and primary infection status of the patients were not analyzed. 3) The lack of long-term follow-up data inhibits survival analysis and prognosis analysis. 6. Conclusion The incidence and mortality rates of candidemia are gradually increasing, with infected patients showing severe symptoms. Candida albicans accounts for the majority of bacteria leading to this disease. In addition to common risk factors such as older age and hypoproteinemia, a history of gastrointestinal and urinary surgery, a history of broad-spectrum antibiotic use, long-term parenteral nutrition support and G + coccyxaemia may also be risk factors for death due to candidemia. In terms of treatment, although the effective rates of triazoles and echinocandins are basically the same, echinocandins are still recommended as first-line treatments. Declarations Funding:This research was supported by Special program of major epidemic prevention and control in Beijing Conflicts of interest：There was no conflicts of interest between authors. Ethics approval:This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Beijing Tsinghua Changgung Hospital affiliated with Tsinghua University. Data and constent is availability for publication. 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Toda M, Williams SR, Berkow EL, Farley MM, Harrison LH, Bonner L, Marceaux KM, Hollick R, Zhang AY, Schaffner W, Lockhart SR, Jackson BR, Vallabhaneni S. Population-Based Active Surveillance for Culture-Confirmed Candidemia - Four Sites, United States, 2012-2016. MMWR Surveill Summ. 2019 Sep 27;68(8):1-15. Alves J, Palma P, Azevedo D, Rello J. Candidemia in the patient with malignancy. Hosp Pract (1995). 2018;46(5):246-252. Lahmer T, Peçanha-Pietrobom PM, Schmid RM, Colombo AL. Invasive fungal infections in acute and chronic liver impairment: A systematic review. Mycoses. 2022;65(2):140-151. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 04 Nov, 2024 Read the published version in BMC Infectious Diseases → Version 1 posted Editorial decision: Revision requested 03 Jun, 2024 Editor assigned by journal 03 Jun, 2024 Submission checks completed at journal 03 Jun, 2024 First submitted to journal 27 May, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4482254","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":310077481,"identity":"781a4273-ea39-4423-bc03-eba4cbaf9d73","order_by":0,"name":"Chenguang Zhang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAvElEQVRIiWNgGAWjYHAC9h8fDGx4+NkbSNAjOaMgTUay5wAJWqR5Phy2MbjhQKRy+fbjFwx4DM7zMNxgYPzwMYcILYw9OQUJEga3eRhnNzBLztxGhBZmCZ6EAwZALcwyB9iYeYnRwibBk9iQYHCOh00igUgtPBLshxkOGBzg4SFaiwRPDhtjg0EyjwTPwWbi/AIMsWfMf/7Y2dsfbz744SMxWoBOM4AyGBuIUg8E7A+IVTkKRsEoGAUjFQAAQdYxVRxhO38AAAAASUVORK5CYII=","orcid":"","institution":"Tsinghua University","correspondingAuthor":true,"prefix":"","firstName":"Chenguang","middleName":"","lastName":"Zhang","suffix":""},{"id":310077483,"identity":"2e2c2fcc-6052-4d05-92d6-11fd0c25a2ea","order_by":1,"name":"sheng wu","email":"","orcid":"","institution":"Tsinghua University","correspondingAuthor":false,"prefix":"","firstName":"sheng","middleName":"","lastName":"wu","suffix":""},{"id":310077485,"identity":"6a034a0a-fc1f-4b74-8c43-5b07677bf340","order_by":2,"name":"xuyan chen","email":"","orcid":"","institution":"Tsinghua University","correspondingAuthor":false,"prefix":"","firstName":"xuyan","middleName":"","lastName":"chen","suffix":""}],"badges":[],"createdAt":"2024-05-27 04:41:50","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4482254/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4482254/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12879-024-10128-2","type":"published","date":"2024-11-04T15:57:41+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":68749936,"identity":"17637581-067e-42f8-a937-d9b44762afb6","added_by":"auto","created_at":"2024-11-11 16:07:49","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":603356,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4482254/v1/add7e575-a05d-4745-93aa-bee496c4b437.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Analysis of the clinical characteristics and treatment of candidemia caused by different pathogens","fulltext":[{"header":"1. Background","content":"\u003cp\u003eCandidemia, which is an opportunistic infection, ranks third among the major bloodstream infectious diseases that threaten public health, and its highest case rate reaches 2.23/10000. The increasing incidence of this disease leads to longer hospital stays and higher mortality rates.\u003csup\u003e\u003cspan additionalcitationids=\"CR2 CR3 CR4\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e"},{"header":"2. Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Clinical Data\u003c/h2\u003e \u003cp\u003eA retrospective study was conducted with a focus on patients who had a clear diagnosis of \"candidiasis\" in our hospital from January 2020 to July 2023. A total of 94 patients, including 54 male patients and 31 female patients, were enrolled in this study according to the following criteria: 1) age older than 18 years, 2) complete clinical data and 3) a single bacterial infection according to blood culture; at least one Candida strain was cultured after excluding the possibility of contamination considering the definition of candidemia, and these blood cultures revealed unequivocal Candida infection \u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe exclusion criteria were as follows: 1) voluntary waiving of treatment halfway through the hospital stay; 2) blood culture demonstrated Candida infection that was likely caused by contamination; 3) 2 or more Candida infections according to blood culture; and 4) simultaneous bacterial bacteremia.\u003c/p\u003e \u003cp\u003e This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Beijing Tsinghua Changgung Hospital affiliated with Tsinghua University.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Research and Statistical Methods\u003c/h2\u003e \u003cp\u003eThe demographic data of the patients (sex, age, etc.), past history, vital signs at onset, laboratory examination, treatment plan and prognosis were collected in this study. Negative results of Candida blood culture after 7 days of treatment was considered to indicate treatment efficacy.\u003c/p\u003e \u003cp\u003eStatistical analysis was performed with SPSS 25.0 software. Count data are expressed as the percentage of the number of patients, and cross-tab was used for multigroup comparisons. Normally distributed data are expressed as (x\u0026thinsp;\u0026plusmn;\u0026thinsp;s), and t tests were used for comparisons of two groups of data. ANOVA was used for comparisons of the average values of multiple groups of data. Nonnormally distributed data are expressed as M (P\u003csub\u003e25\u003c/sub\u003e, P\u003csub\u003e75\u003c/sub\u003e), and a nonparametric test was used to analyze data among multiple groups. Logistic regression analysis was used to analyze the relationships between the observed indicators and patient prognosis. Survival analysis was used to determine the relationships between different group indicators and patient mortality. When P\u0026thinsp;\u0026lt;\u0026thinsp;0.05, the difference was considered clinically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Research Results","content":"\u003cp\u003eA total of 94 patients, including 59 males and 35 females, were enrolled in this study. The average age at onset was 66.36\u0026thinsp;\u0026plusmn;\u0026thinsp;13.88 years, with 66.15\u0026thinsp;\u0026plusmn;\u0026thinsp;2.69 years being the age of onset in males and 66.55\u0026thinsp;\u0026plusmn;\u0026thinsp;3.19 years being the age of onset in females. No significant difference was observed between these groups (t=-0.09, P\u0026thinsp;=\u0026thinsp;0.92). In this study, 22 patients (23.40%) died.\u003c/p\u003e \u003cp\u003e \u003cem\u003eCandida albicans\u003c/em\u003e (\u003cem\u003eC. albicans\u003c/em\u003e) accounted for 46.8% of the cases, \u003cem\u003eCandidia parapsilosis\u003c/em\u003e (\u003cem\u003eC. parapsilosis\u003c/em\u003e) accounted for 23.4% of the cases, \u003cem\u003eCandidia glabrata\u003c/em\u003e (\u003cem\u003eC. glabrata\u003c/em\u003e) accounted for 17.0% of the cases, and \u003cem\u003eCandida tropicalis\u003c/em\u003e (\u003cem\u003eC. tropicalis\u003c/em\u003e) accounted for 12.8% of the cases (44 vs. 22 vs. 16 vs. 12). There was no significant difference in the age of onset or mortality of patients in the different pathogen groups (F\u003csub\u003e1\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.26, P\u003csub\u003e1\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.85; F\u003csub\u003e2\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;3.31, P\u003csub\u003e2\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.34) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). In addition, during the process of data collection, we found that 30 patients (31.91%) had gram-positive (G\u003csup\u003e+\u003c/sup\u003e) coccidiosis within 10 days (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBasic issues in different group\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItems\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eC. albicans\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eC. parapsilosis\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eC. glabrata\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eC. tropicalis\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eResult(χ\u003csup\u003e2\u003c/sup\u003e/F)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31(70.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15(68.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7(43.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6(50.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e59(62.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge(years old)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(66.61\u0026thinsp;\u0026plusmn;\u0026thinsp;1.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(66.68\u0026thinsp;\u0026plusmn;\u0026thinsp;2.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(63.68\u0026thinsp;\u0026plusmn;\u0026thinsp;4.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(68.08\u0026thinsp;\u0026plusmn;\u0026thinsp;5.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(66.31\u0026thinsp;\u0026plusmn;\u0026thinsp;13.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of Tumor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18(40.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(36.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5(31.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6(50.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBillary surgery\u003csup\u003e\u003cspan citationid=\"CR1\" 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\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(50.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10(62.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4(33.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBroad-spectrum antibiotic use\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27(61.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10(45.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10(62.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3(25.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrinary tract surgery\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(9.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(9.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(12.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2(16.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.87\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChemotherapy\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(6.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(4.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(6.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6(13.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(40.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3(18.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCOPD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(4.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(4.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(6.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3(25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeart disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(6.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(22.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(6.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCKD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(4.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(4.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(12.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMental disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(9.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(9.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(6.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCirhosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(9.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(4.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(6.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.92\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImmune disease\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(2.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0(0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eG\u003csup\u003e+\u003c/sup\u003ecoccidiosis infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12(27.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(40.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5(31.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4(33.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeath\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10(22.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(22.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(12.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5(41.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003e1.History of billary surgery,gastrointestinal surgery,broad-spectrum antibiotic use,urinary tract surgery,Chemotherapy and parenteral nutrition support(PN) in these two weeks.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eBroad-spectrum antibiotic use, Body mass index(BMI), albumin(ALB), parenteral nutrition(PN) support, history of gastrointestinal surgery, history of urinary tract surgery and history of G\u003csup\u003e+\u003c/sup\u003e coccidiosis infection were risk factors for death in patients with candidemia (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The longer the duration of parenteral nutrition was, the higher mortality rate (10.57, 95% OR 0.45\u0026ndash;0.82, P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). In terms of recent broad-spectrum antibiotic use, patients were divided into a low-level antibiotic group (third-generation cephalosporins, quinolones, etc.) and a high-level antibiotic group (enzyme inhibitors, carbapenems, etc.). The level of antibiotics use, the duration of antibiotic treatment and the mortality rate were positively correlated (Coefficient of correlation:0.91,P\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLogistic of death in different issues\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItems\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWals\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95% OR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBroad-spectrum antibiotic use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.01ཞ1.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.10ཞ1.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eALB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.93ཞ1.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.17ཞ29.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGastrointestinal surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.10ཞ25.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrinary tract surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.20ཞ39.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eG\u003csup\u003e+\u003c/sup\u003ecoccidiosis infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.04ཞ1.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.86ཞ0.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFever was the main symptom among the clinical manifestations, while the mean arterial pressure(MAP) was normal at the time of onset, and there was no difference in terms of different pathogens (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). According to laboratory data, the inflammatory indexes C-reactive prtein (CRP)and Procalcitonin (PCT) were increased, while the lymphocyte count and the serum ALB and hemoglobin(HB)levels were decreased. White blood cell(WBC) counts in the \u003cem\u003eC. albicans\u003c/em\u003e and \u003cem\u003eC. tropicalis\u003c/em\u003e groups were significantly greater (F\u0026thinsp;=\u0026thinsp;3.95, P\u0026thinsp;=\u0026thinsp;0.01) than those in the other groups. Moreover, the \u003cem\u003eC. tropicalis\u003c/em\u003e group had higher serum creatinine levels and shorter time to positivity(TTD) (F\u003csub\u003e1\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;8.40, P\u003csub\u003e1\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.03; F\u003csub\u003e2\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;5.03, P\u003csub\u003e2\u003c/sub\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01). There were no significant differences in age, BMI, body temperature or MAP, PCT, CRP, WBC, HB, platemet(PLT), lymphocyte, transaminase(AST), or ALB levels among the different pathogen groups.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClinical presentation and laboratory results in differents groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItems\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eC. albicans\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eC. parapsilosis\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eC. glabrata\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eC. tropicalis\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eResult(F/H)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBMI(kg/m\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(22.62\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(22.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(20.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(20.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(21.92\u0026thinsp;\u0026plusmn;\u0026thinsp;0.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eT(\u003c/b\u003e\u003csup\u003e\u003cb\u003eo\u003c/b\u003e\u003c/sup\u003e\u003cb\u003eC)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(38.22\u0026thinsp;\u0026plusmn;\u0026thinsp;0.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(37.95\u0026thinsp;\u0026plusmn;\u0026thinsp;0.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(37.92\u0026thinsp;\u0026plusmn;\u0026thinsp;0.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(37.93\u0026thinsp;\u0026plusmn;\u0026thinsp;0.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(38.07\u0026thinsp;\u0026plusmn;\u0026thinsp;0.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.45\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMAP(mmHg)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(106.40\u0026thinsp;\u0026plusmn;\u0026thinsp;2.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(105.68\u0026thinsp;\u0026plusmn;\u0026thinsp;2.79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(102.62\u0026thinsp;\u0026plusmn;\u0026thinsp;3.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(107.16\u0026thinsp;\u0026plusmn;\u0026thinsp;5.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(105.93\u0026thinsp;\u0026plusmn;\u0026thinsp;1.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.77\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWBC(10\u003c/b\u003e\u003csup\u003e\u003cb\u003e9\u003c/b\u003e\u003c/sup\u003e\u003cb\u003e/L)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(10.47\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(6.92\u0026thinsp;\u0026plusmn;\u0026thinsp;0.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(7.76\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(11.90\u0026thinsp;\u0026plusmn;\u0026thinsp;2.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(9.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eN(U/L)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(9.27\u0026thinsp;\u0026plusmn;\u0026thinsp;0.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(4.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(5.52\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(11.38\u0026thinsp;\u0026plusmn;\u0026thinsp;0.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(7.77\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e5.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eY(U/L)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(0.69\u0026thinsp;\u0026plusmn;\u0026thinsp;0.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(0.94\u0026thinsp;\u0026plusmn;\u0026thinsp;0.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(0.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(0.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(0.76\u0026thinsp;\u0026plusmn;\u0026thinsp;0.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHB(g/L)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(95.40\u0026thinsp;\u0026plusmn;\u0026thinsp;2.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(97.81\u0026thinsp;\u0026plusmn;\u0026thinsp;3.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(88.68\u0026thinsp;\u0026plusmn;\u0026thinsp;5.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(88.16\u0026thinsp;\u0026plusmn;\u0026thinsp;5.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(94.03\u0026thinsp;\u0026plusmn;\u0026thinsp;1.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePLT(10\u003c/b\u003e\u003csup\u003e\u003cb\u003e12\u003c/b\u003e\u003c/sup\u003e\u003cb\u003e/l)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(144.89\u0026thinsp;\u0026plusmn;\u0026thinsp;16.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(192.90\u0026thinsp;\u0026plusmn;\u0026thinsp;23.79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(148.31\u0026thinsp;\u0026plusmn;\u0026thinsp;21.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(140.50\u0026thinsp;\u0026plusmn;\u0026thinsp;29.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(140.50\u0026thinsp;\u0026plusmn;\u0026thinsp;19.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.77\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePCT(ng/L)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(0.41,2.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(0.32,3.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(0.27,1.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(0.46,4.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(0.35,2.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.26\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCRP(mg/L)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(44.75,131.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(24.25,84.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(29.50,80.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(13.75,152.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(27.50,113.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAST(U/L)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(20.75,72.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(24.12,67.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(26.12,46.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(16.50,79.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(21.55,61.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCRE(mmol/L)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(46.22,102.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(47.75,126.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(49.25,159.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(94.25,206.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(50.25,143.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e8.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eALB(g/L)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(30.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(31.29\u0026thinsp;\u0026plusmn;\u0026thinsp;1.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(29.35\u0026thinsp;\u0026plusmn;\u0026thinsp;1.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(28.83\u0026thinsp;\u0026plusmn;\u0026thinsp;1.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(30.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTTD(hour)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(45.16\u0026thinsp;\u0026plusmn;\u0026thinsp;3.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(33.18\u0026thinsp;\u0026plusmn;\u0026thinsp;3.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(39.56\u0026thinsp;\u0026plusmn;\u0026thinsp;5.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(22.16\u0026thinsp;\u0026plusmn;\u0026thinsp;3.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(38.44\u0026thinsp;\u0026plusmn;\u0026thinsp;2.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e5.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn this study, 74 patients completed β-D-glucan(BDG) examination, but the percentage of patients with positive results was only 68.91% (49 vs. 25) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Triazole, echinocandins and amphotericin B (54 vs. 37 vs. 3) were used as antifungal medicines in this study. Triazole, which contains fluconazole and voriconazole, was used to treat 57.45% of the patients, and fluconazole was the most commonly used medicine (35 vs. 19). Echinocandins, which mainly included carbafenine, was used to treat 39.36% of the patients. Seventy-one patients, including 1 patient treated with amphotericin B and 70 patients treated with triazoles and echinocandins, were asked to provide blood cultures after 7 days of treatment. The efficacy of triazoles was similar to that of echinocandins (χ\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.05, P\u0026thinsp;=\u0026thinsp;0.81). After comparing the efficacy of triazoles and echinocandins across the four of pathogen groups, no measurable difference was detected (χ\u003csub\u003e1\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;1.20, P\u003csub\u003e1\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.75; χ\u003csub\u003e2\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.05, P\u003csub\u003e2\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.81) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eEffective of different drugs treatment\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eTriazoles\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eEchinocandins\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEffective\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon-effective\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEffective\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNon-effective\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eC. albicans\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eC. parapsilosis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eC. glabrata\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eC. tropicalis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOverall\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eOverall:χ\u003csup\u003e2\u003c/sup\u003e=0.05, P\u0026thinsp;=\u0026thinsp;0.81;Triazoles: χ\u003csup\u003e2\u003c/sup\u003e༝1.20,P\u0026thinsp;=\u0026thinsp;0.75;Echinocandins༚χ\u003csup\u003e2\u003c/sup\u003e༝1.58, P\u0026thinsp;=\u0026thinsp;0.66\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eCandidemia is a fatal disease that is difficult to diagnose in America and Europe. \u003cem\u003eCandida albicans\u003c/em\u003e is the most common causative agent of this condition, accounting for 89.5% of candidemia cases. However, \u003cem\u003eCandida albicans\u003c/em\u003e accounted for 46.8% of the cases identified in our study, which is less than that reported in other studies. Older age, immunosuppressive drug use (glucocorticoids, chemotherapeutic drugs, immunosuppressants, etc.), neutropenia, complete parenteral nutrition therapy, organ transplantation, renal insufficiency, tumor history, hypoproteinemia, anemia and severe sepsis are risk factors for candidemia.\u003csup\u003e\u003cspan additionalcitationids=\"CR7 CR8 CR9 CR10\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e Moreover, we found that a history of gastrointestinal surgery, a history of urinary tract surgery, a recent history of G\u003csup\u003e+\u003c/sup\u003e coccyxemia and broad-spectrum antibiotic use, especially high-level broad-spectrum antibiotic use, may also be risk factors for candidemia. There are several reasons for this. 1) Candida usually colonizes the gastrointestinal tract and urinary tract, while surgeries can cause the bacteria to transfer to other places. The high intestinal colonization rate of \u003cem\u003eCandida albicans\u003c/em\u003e also increases the incidence of infection in patients who undergo gastrointestinal surgery. 2) High-level broad-spectrum antibiotic use easily causes intestinal and urinary tract flora imbalances in patients. 3) Postoperative patients have low immunity. 4) Increased parenteral nutrition in patients after gastrointestinal surgery exacerbates flora imbalances and shifts. Notably, 31.91% of patients had a history of G\u003csup\u003e+\u003c/sup\u003e coccusemia within 10 days before the onset of candidemia, among whom 40% were postoperative patients. G\u003csup\u003e+\u003c/sup\u003e coccusemia causes increased vascular permeability, accelerating the entry of Candida into the blood. In addition, severe bacteremia can cause immunosuppression, and high-level broad-spectrum antibiotics also contribute to candidemia.\u003c/p\u003e \u003cp\u003eThe detection of candidemia lacks specificity. Fever was the most common symptom that was observed in the present study. As in previous research, WBC and CRP levels increased slightly, while CRE, ALT, and AST levels were within normal limits.\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e \u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e The lymphocyte count was low overall, while there was no significant difference between the different pathogenic groups. The lymphocyte count is an indicator of cellular immunity and nutritional status. Low immunity, poor postoperative nutritional status, hypoproteinemia, anemia, and immunosuppression can all lead to low lymphocyte counts.\u003c/p\u003e \u003cp\u003eIn this study, 12 patients received antifungal treatment before BDG detection, which might be the main reason for the lower positivity rate. However, the etiological diagnosis cannot be determined in a short period. Similar to most studies, the median TTD in this study was 38.44\u0026thinsp;\u0026plusmn;\u0026thinsp;2.14 hours, and the results were relatively limited. Therefore, most studies recommend BDG detection to help diagnose invasive candidiasis, especially candidemia, and this approach has a sensitivity of 87.1% and specificity of 96%. \u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan additionalcitationids=\"CR14\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e We still recommend BDG detection as an important method for the diagnosis of candidemia. In addition, the \u003cem\u003eCandida tropicalis\u003c/em\u003e group had more abnormal renal function, and the TTD was shorter (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). The literature has pointed out that \u003cem\u003eCandida tropicalis\u003c/em\u003e grows faster than other species, with a larger number of colonies in the blood, stronger antibiotic resistance and mucosal penetration and the ability to easily form biofilms with strong adhesion; these properties increase the invasion of this pathogen compared with that of other species.\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eTriazole, echinocandins, polyene, and 5-fluorouracil are commonly used antifungal drugs. In this study, except for 3 patients who were treated with amphotericin B, the other patients were treated with triazoles (including fluconazole and voriconazole) and echinocandins (carbofen). No difference in the effects of treatment with triazoles or echinocandins (χ\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.05, P\u0026thinsp;=\u0026thinsp;0.81) was observed, and no difference was observed in the effects of treatments targeting different pathogenic bacteria. However, echinocandins are still recommended as a first-line treatment for several reasons. 1) Compared with fluconazole and echinocandins, there is no significant difference in the prognosis of treatment in terms of patient age, race, sex, past history, etc., but in terms of the readmission rate, the prognosis of patients treated with echinocandins is significantly lower than that of patients treated with fluconazole (P\u0026thinsp;=\u0026thinsp;0.019)\u003csup\u003e16\u003c/sup\u003e.2) Compared with that of the \u003cem\u003eCandida albicans\u003c/em\u003e group (MIC\u003csub\u003e50\u003c/sub\u003e, MIC\u003csub\u003e90\u003c/sub\u003e), the carbafenacin group had MIC\u003csub\u003e50\u003c/sub\u003e and MIC\u003csub\u003e90\u003c/sub\u003e values of 0.03 and 0.12, and the fluconazole group had MIC\u003csub\u003e50\u003c/sub\u003e and MIC\u003csub\u003e90\u003c/sub\u003e values of 0.25 and 0.5; however, carbafenacin has a better antibacterial effect, and the blood culture became negative more quickly after treatment with carbafenacin\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e. 3) The resistance rate of echinocandins was relatively low, and there was no echinocandin resistance, while 3 patients exhibited triazole resistance in our study. Studies have shown that the rate of resistance to echinocandins is less than 0.1%, while that to triazole is 20%\u003csup\u003e4,17\u003c/sup\u003e. 4) Compared with echinocandins, fluconazole is more likely to cause liver injury\u003csup\u003e\u003cspan additionalcitationids=\"CR18 CR19 CR20\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e. 5) Most patients with candidiasis have serious symptoms, and echinocandins are used as first-line medicine while adopting the \"down-the-ladder\" anti-infection approach.\u003c/p\u003e \u003cp\u003e \u003cb\u003e5. Limitations\u003c/b\u003e \u003c/p\u003e \u003cp\u003e1) As this was a retrospective study and single-center study, the amount of data was relatively small, and possible sampling bias could exist. 2) The sources of the patients were unified, and the evaluation of disease severity was deficient. The APACHE II score and primary infection status of the patients were not analyzed. 3) The lack of long-term follow-up data inhibits survival analysis and prognosis analysis.\u003c/p\u003e"},{"header":"6. Conclusion","content":"\u003cp\u003eThe incidence and mortality rates of candidemia are gradually increasing, with infected patients showing severe symptoms. \u003cem\u003eCandida albicans\u003c/em\u003e accounts for the majority of bacteria leading to this disease. In addition to common risk factors such as older age and hypoproteinemia, a history of gastrointestinal and urinary surgery, a history of broad-spectrum antibiotic use, long-term parenteral nutrition support and G\u003csup\u003e+\u003c/sup\u003e coccyxaemia may also be risk factors for death due to candidemia. In terms of treatment, although the effective rates of triazoles and echinocandins are basically the same, echinocandins are still recommended as first-line treatments.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eFunding:This research was supported by Special program of major epidemic prevention and control in Beijing\u003c/p\u003e\n\u003cp\u003eConflicts of interest：There was no conflicts of interest between authors.\u003c/p\u003e\n\u003cp\u003eEthics approval:This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Beijing Tsinghua Changgung Hospital affiliated with Tsinghua University.\u003c/p\u003e\n\u003cp\u003eData and constent is availability for publication.\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; contributions:Chenguang Zhang was responsible for data collection,literature reviewed and paper writing. Xu Yan Chen was responsible for the review and revision of the paper. Sheng Wu was responsible for paper writing and reviewing.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eZuo XS, Liu Y, Hu K. Epidemiology and risk factors of candidemia due to Candida parapsilosis in an intensive care unit. Rev Inst Med Trop Sao Paulo. 2021 Mar 24;63:e20. \u003c/li\u003e\n\u003cli\u003eDe Rosa FG, Busca A, Capparella MR, Yan JL, Aram JA. Invasive Candidiasis in Patients with Solid Tumors Treated with Anidulafungin: A Post Hoc Analysis of Efficacy and Safety of Six Pooled Studies. Clin Drug Investig. 2021 Jun;41(6):539-548.\u003c/li\u003e\n\u003cli\u003eLindberg E, Hammarstr\u0026ouml;m H, Ataollahy N, Kondori N. Species distribution and antifungal drug susceptibilities of yeasts isolated from the blood samples of patients with candidemia. Sci Rep. 2019 Mar 7;9(1):3838.\u003c/li\u003e\n\u003cli\u003eSiopi M, Tarpatzi A, Kalogeropoulou E, Damianidou S, Vasilakopoulou A, Vourli S, Pournaras S, Meletiadis J. Epidemiological Trends of Fungemia in Greece with a Focus on Candidemia during the Recent Financial Crisis: a 10-Year Survey in a Tertiary Care Academic Hospital and Review of Literature. Antimicrob Agents Chemother. 2020 Feb 21;64(3):e01516-19.\u003c/li\u003e\n\u003cli\u003eBarchiesi F, Orsetti E, Mazzanti S, Trave F, Salvi A, Nitti C, Manso E. Candidemia in the elderly: What does it change? PLoS One. 2017 May 11;12(5):e0176576.\u003c/li\u003e\n\u003cli\u003eVannini M, Emery S, Lieutier-Colas F, et al. Epidemiology of candidemia in NICE area, France: A five-year study of antifungal susceptibility and mortality. \u003cem\u003eJ Mycol Med\u003c/em\u003e. 2022;32(1):101210. \u003c/li\u003e\n\u003cli\u003eMcCarty TP, White CM, Pappas PG. Candidemia and Invasive Candidiasis. Infect Dis Clin North Am. 2021;35(2):389-413. \u003c/li\u003e\n\u003cli\u003eSurviving Sepsis Campaign International Guidelines. Pediatrics. 2020;145(5):e20200629. \u003c/li\u003e\n\u003cli\u003eArastehfar A, Yazdanpanah S, Bakhtiari M, et al. Epidemiology of candidemia in Shiraz, southern Iran: A prospective multicenter study (2016-2018). Med Mycol. 2021;59(5):422-430. \u003c/li\u003e\n\u003cli\u003eRossow JA, Gharpure R, Brennan J, Relan P, Williams SR, Vallabhaneni S, Jackson BR, Graber CR, Hillis SR, Schaffner W, Dunn JR, Jones TF. Injection Drug Use-Associated Candidemia: Incidence, Clinical Features, and Outcomes, East Tennessee, 2014-2018. J Infect Dis. 2020 Sep 2;222(Suppl 5):S442-S450. \u003c/li\u003e\n\u003cli\u003eMcCarthy MW, Walsh TJ. Candidemia in the cancer patient: diagnosis, treatment, and future directions. Expert Rev Anti Infect Ther. 2018;16(11):849-854. \u003c/li\u003e\n\u003cli\u003eKayaaslan B, Eser F, Kaya Kalem A, Bilgic Z, Asilturk D, Hasanoglu I, Ayhan M, Tezer Tekce Y, Erdem D, Turan S, Mumcuoglu I, Guner R. Characteristics of candidemia in COVID-19 patients; increased incidence, earlier occurrence and higher mortality rates compared to non-COVID-19 patients. Mycoses. 2021 Sep;64(9):1083-1091.\u003c/li\u003e\n\u003cli\u003eDe Pascale G, Posteraro B, D\u0026apos;Arrigo S, et al. (1,3)-\u0026beta;-D-Glucan-based empirical antifungal interruption in suspected invasive candidiasis: a randomized trial. Crit Care. 2020;24(1):550. Published 2020 Sep 5. \u003c/li\u003e\n\u003cli\u003eZhang Y,Bo HS,Du JY,et al.Interference factors of G test in the diagnosis of invasive fungal disease.China J Mycol,2022,17(01):69-73.\u003c/li\u003e\n\u003cli\u003eHage CA, Carmona EM, Epelbaum O, et al. Microbiological Laboratory Testing in the Diagnosis of Fungal Infections in Pulmonary and Critical Care Practice. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med 2019; 200:535.\u003c/li\u003e\n\u003cli\u003eRicotta EE, Lai YL, Babiker A, et al. Invasive Candidiasis Species Distribution and Trends, United States, 2009-2017. J Infect Dis 2021; 223:1295.\u003c/li\u003e\n\u003cli\u003eBassetti M, Giacobbe DR, Vena A, Wolff M. Diagnosis and Treatment of Candidemia in the Intensive Care Unit. Semin Respir Crit Care Med. 2019;40(4):524-539. doi:10.1055/s-0039-1693704\u003c/li\u003e\n\u003cli\u003eGold JAW, Seagle EE, Nadle J, et al. Treatment Practices for Adults With Candidemia at 9 Active Surveillance Sites-United States, 2017-2018. Clin Infect Dis. 2021 Nov 2;73(9):1609-1616.\u003c/li\u003e\n\u003cli\u003eToda M, Williams SR, Berkow EL, Farley MM, Harrison LH, Bonner L, Marceaux KM, Hollick R, Zhang AY, Schaffner W, Lockhart SR, Jackson BR, Vallabhaneni S. Population-Based Active Surveillance for Culture-Confirmed Candidemia - Four Sites, United States, 2012-2016. MMWR Surveill Summ. 2019 Sep 27;68(8):1-15. \u003c/li\u003e\n\u003cli\u003eAlves J, Palma P, Azevedo D, Rello J. Candidemia in the patient with malignancy. Hosp Pract (1995). 2018;46(5):246-252. \u003c/li\u003e\n\u003cli\u003eLahmer T, Pe\u0026ccedil;anha-Pietrobom PM, Schmid RM, Colombo AL. Invasive fungal infections in acute and chronic liver impairment: A systematic review. Mycoses. 2022;65(2):140-151. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Candidemia, β-D-glucan, triazoles, echinocandins","lastPublishedDoi":"10.21203/rs.3.rs-4482254/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4482254/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eTo analyzing of the clinical characteristics and treatment of candidemia caused by different pathogens.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA retrospective study was conducted with a focus on patients who had a clear diagnosis of \"candidiasis\" in our hospital from January 2020 to July 2023. The demographic data, past history, vital signs at onset, laboratory examination, treatment plan and prognosis were collected and analyzed.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThere was no significant difference in the age of onset or mortality of patients in the different pathogen groups (F\u003csub\u003e1\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.26,P\u003csub\u003e1\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.85;F\u003csub\u003e2\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;3.31, P\u003csub\u003e2\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.34) .Broad-spectrum antibiotic use, BMI, albumin, parenteral nutrition support, history of gastrointestinal surgery, history of urinary tract surgery and history of G\u003csup\u003e+\u003c/sup\u003e coccidiosis infection were risk factors for death in patients with candidemia. WBC counts in the C. albicans and C. tropicalis groups were significantly greater (F\u0026thinsp;=\u0026thinsp;3.95, P\u0026thinsp;=\u0026thinsp;0.01) than those in the other groups. The C. tropicalis group had higher serum creatinine levels and shorter TTD (F\u003csub\u003e1\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;8.40, P\u003csub\u003e1\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.03; F\u003csub\u003e2\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;5.03, P\u003csub\u003e2\u003c/sub\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01).The efficacy of triazoles was similar to that of echinocandins (χ\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.05, P\u0026thinsp;=\u0026thinsp;0.81). After comparing the efficacy of triazoles and echinocandins across the four of pathogen groups, no measurable difference was detected (χ\u003csub\u003e1\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;1.20, P\u003csub\u003e1\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.75; χ\u003csub\u003e2\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.05, P\u003csub\u003e2\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.81) .\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eIn addition to common risk factors such as older age and hypoproteinemia, a history of gastrointestinal and urinary surgery, a history of broad-spectrum antibiotic use, long-term parenteral nutrition support and G\u003csup\u003e+\u003c/sup\u003e coccyxaemia may also be risk factors for death due to candidemia. Echinocandins are recommended as first-line treatments.\u003c/p\u003e","manuscriptTitle":"Analysis of the clinical characteristics and treatment of candidemia caused by different pathogens","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-14 04:47:46","doi":"10.21203/rs.3.rs-4482254/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-06-03T15:30:12+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-06-03T15:19:02+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-06-03T08:03:30+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Infectious Diseases","date":"2024-05-27T04:40:35+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9973a3d6-b789-47b8-b891-688eaa996bda","owner":[],"postedDate":"June 14th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-11-11T16:01:26+00:00","versionOfRecord":{"articleIdentity":"rs-4482254","link":"https://doi.org/10.1186/s12879-024-10128-2","journal":{"identity":"bmc-infectious-diseases","isVorOnly":false,"title":"BMC Infectious Diseases"},"publishedOn":"2024-11-04 15:57:41","publishedOnDateReadable":"November 4th, 2024"},"versionCreatedAt":"2024-06-14 04:47:46","video":"","vorDoi":"10.1186/s12879-024-10128-2","vorDoiUrl":"https://doi.org/10.1186/s12879-024-10128-2","workflowStages":[]},"version":"v1","identity":"rs-4482254","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4482254","identity":"rs-4482254","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}