Clinical insights into mixed Candida and bacterial bloodstream infections: a retrospective cohort study

作者：Ho‐Yin Huang, Ying‐Chi Lin, Po‐Liang Lu, Ya‐Ling Wang, Tun‐Chieh Chen, Ko Chang, Shang‐Yi Lin · 发表于：Microbiology Spectrum · 年份：2025 · DOI：10.1128/spectrum.01684-25 · 被引用次数：8 · 研究领域：Antifungal resistance and susceptibility、Bacterial Identification and Susceptibility Testing、Antimicrobial Resistance in Staphylococcus

ABSTRACT Mixed bloodstream infections (BSIs) involving Candida and other bacterial pathogens present significant diagnostic and therapeutic challenges. The incidence of these co-infections has been increasing. However, the limited literature on this topic necessitates a deeper understanding of its epidemiological and clinical characteristics. This retrospective study evaluated adult patients with candidemia across three hospitals in Taiwan between January 2014 and December 2020. Mixed Candida /bacterial BSIs were defined as the concurrent isolation of bacterial species from any set of blood cultures within 1 week of the initial Candida culture. The clinical features and 30-day mortality of mixed Candida /bacterial BSIs were investigated. Among 766 patients with candidemia, 193 (25.2%) had mixed Candida /bacterial BSIs. The 30-day mortality for mixed infections was significantly higher than for monomicrobial candidemia (62.7% vs. 51.7%, P = 0.009). The mortality rates and intervals between Candida and bacterial blood culture isolation had a negative correlation ( P = 0.004). In the mixed Candida /bacterial BSI cases, the most common bacteria included coagulase-negative staphylococci, Enterococcus spp., and Klebsiella spp. Co-infection with vancomycin-resistant Enterococcus had a significantly higher mortality rate than mono-candidemia ( P = 0.015). Significant predictors of 30-day mortality included high Pitt score, high sequential organ failure assessment (SOFA) score, inappr...