Comparison of risk factors for non-albicans candida and candida albicans infections in the intensive care unit

Objective To determine the differences of risk factors for non-albicans candida and candida albicans infections among patients in the intensive care unit (ICU). Methods One hundred and three patients with ICU-acquired candida infections were retrospectively analyzed from February 2003 to April 2009. These patients were divided into non-albicans candida species group and candida albicans group.Multiple risk factors were analyzed between two groups. Results Of these patients, 46 patients (44.7%)had infections of non-albicans candida species and 57 patients (55.3%) had candida albicans infection.Among non-albicans candida species, candida glabrata, candida parapsilosis, candida tropicalis, candida krusei and others candida accounted for 19 patients (18.4%), 13 patients (12.6%), 10 patients (9.7%), 2 patients (1.9%) and 2 patients ( 1.9% ), respectively. Multivariate Logistic regression models revealed that central venous catheter (CVC) insertion time > 2 d (OR = 32.477,95% CI:4.905-215.035,P=0.000),total parenteral nutrition (OR =3.119,95% CI:1.214-8.015,P =0.018) and fluconazole prophylaxis therapy (OR = 5.084,95%CI: 1.319-19.596,P = 0.018) were highly correlated with non-albicans candida species infections. Conclusion CVC insertion time > 2 d, total parenteral nutrition and fluconazole prophylaxis therapy are independent risk factors of non-albicans candida species infections and can be used in empirical antifungal therapy. Key words: Candida albicans;  Risk factors;  Intensive care units