Table 1 Demographics and clinical risk factors of the elderly and younger patients
with candidemia
Characteristics
Elderly Patients
(n = 63)
Younger Patients
(n = 91)
Age (years) a
75.4 ± 12.7
41.2 ± 11.9
Male sex
51 (81.0)
63 (69.2)
a
LOS
45.3 ± 32.8
39.4 ± 31.5
Hospital settings
ICUs
31 (49.2)
22 (24.2)
Medical wards
14 (22.2)
34 (37.4)
Surgical wards
12 (19.0)
27 (29.7)
b
Others
6 (9.5)
8 (8.8)
Host-related risk factors
Solid tumour
15 (23.8)
6 (6.6)
b
Haematological malignancy
3 (4.8)
14 (15.4)
Neutropenia
5 (7.9)
21 (23.1)
Diabetes mellitus
24 (38.1)
10 (11.0)
Chronic renal failure
18 (28.6)
9 (9.9)
Prior immunosuppressive drugs
16 (25.4)
27 (29.7)
Severe hypoalbuminemia
13 (20.6)
11 (12.1)
Hospital-related risk factors
Surgeries
14 (22.2)
30 (33.0)
Abdominal surgical operations
9 (14.3)
14 (15.4)
ICU stay ≥ 5 days
19 (30.2)
8 (8.8)
Multiple blood product transfusion
8 (12.7)
16 (17.6)
Parental nutrition
20 (31.7)
17 (18.7)
Receipt of mechanical ventilation
27 (42.9)
22 (24.2)
CVC placement
32 (50.8)
29 (31.9)
Urethral catheter placement
34 (54.0)
32 (35.2)
b
Prior antibacterial exposure
63 (100.0)
89 (97.8)
≥ 3 kinds of prior antibacterial drugs
29 (46.0)
37 (40.7)
Data are presented as n (%) or means ± SD.
ICU, intensive care unit; LOS, length of stay; CVC, central venous catheter.
a
Two-independent samples t-test; bFisher’s exact test; Unspecified: Chi-square test.
1
p value
<0.001
0.103
0.265
0.001
0.046
0.136
0.876
0.002
0.039
0.014
0.001
0.003
0.561
0.151
0.147
0.851
0.001
0.411
0.062
0.014
0.018
0.020
0.645
0.508
Table 2 Antifungal therapy started before and after the microbiological
documentation of Candida in the bloodstream.
Elderly Patients
(n = 63)
Characteristics
Younger
Patients
(n = 91)
Antifungal
therapy
administered
before
22 (34.9%)
50 (54.9%)
microbiological documentation
Treatment method
Prophylactic treatment
7 (11.1%)
18 (19.8%)
Empiric treatment
12 (19.0%)
25 (27.5%)
a
Undetermined
3 (4.8%)
7 (7.7%)
Agents selection
Fluconazole
16 (25.4%)
34 (37.4%)
a
Itraconazole
3 (4.8%)
12 (13.2%)
Voriconazole a
3 (4.8%)
4 (4.4%)
Antifungal therapy administered/changed after
28 (44.4%)
39 (42.9%)
microbiological documentation
Agents selection
Fluconazole
4 (6.3%)
14 (15.4%)
a
Itraconazole
6 (9.5%)
4 (4.4%)
a
Voriconazole
4 (6.3%)
6 (6.6%)
a
Micafungin
3 (4.8%)
5 (5.5%)
Caspofungin
11 (17.5%)
10 (11.0%)
Overall
Triazoles usage
36 (57.1%)
72 (79.1%)
Echinocandins usage
14 (22.2%)
15 (16.5%)
Absence of antifungal therapies
16 (25.4%)
11 (12.1%)
Data are presented as n (%).
Antifungal agents were changed in 3 elderly patients and 7 younger patients.
a
Fisher’s exact test; Unspecified: Chi-square test.
2
p value
0.014
0.151
0.299
0.694
0.119
0.083
0.775
0.845
0.086
0.349
0.786
0.867
0.250
0.003
0.370
0.033
Table 3
Laboratory data and outcomes of the elderly and younger patients with
candidemia
Characteristics
Laboratory data
Hemoglobin (g/L)
Platelet count (×109/L)
Serum creatine (μmol/L)
Blood sugar (mmol/L)
Serum sodium (mmol/L)
Serum potassium (mmol/L)
Total bilirubin (μmol/L) b
High Fever (T>39℃) a
Concurrent bacteraemia
APACHE II score
Age-adjusted APACHE II score
Septic shock a
30-day mortality rate a
Elderly Patients
(n = 63)
Younger Patients
(n = 91)
86.9 ± 29.1
163.4 ± 93.7
112.0 ± 95.3
9.3 ± 5.1
138.6 ± 5.8
93.8 ± 31.2
153.9 ± 117.5
83.6 ± 67.4
6.8 ± 2.9
137.5 ± 5.5
0.168
0.594
3.9 ± 1.0
16.3 (6.2-31.8)
19 (30.2)
8 (12.7)
20.3 ± 8.1
16.2 ± 7.7
27 (42.9)
20 (31.7)
3.8 ± 0.9
14.1 (8.4-30.9)
35 (38.5)
15 (16.5)
14.8 ± 7.5
14.0 ± 7.2
26 (28.6)
16 (17.6)
0.518
0.390
0.288
0.517
Data are presented as n (%), means ± SD or median (IQR).
APACHE, Acute Physiology and Chronic Health Evaluation.
a
Chi-square test; bMann-Whitney U test; Unspecified: Two-independent samples
t-test.
3
p value
0.032
0.001
0.234
0.001
0.072
0.067
0.041
Table 4 Univariate analysis of outcome in elderly patients with candidemia
Non-survived
Survived
(n = 20)
(n = 43)
Chronic renal failure
9 (45.0)
9 (20.9)
0.049
Severe hypoalbuminemia
8 (40.0)
5 (11.6)
0.040
Receipt of mechanical ventilation
14 (70.0)
12 (30.2)
0.003
3 (15.0)
19 (44.2)
Absence of antifungal therapies
10 (50.0)
6 (14.0)
0.002
Platelet count ≤ 100 g/L×109/L
7 (35.0)
5 (11.6)
0.028
Serum creatine ≥180 μmol/L
8 (40.0)
7 (16.3)
0.040
Total bilirubin ≥30 μmol/L
9 (45.0)
7 (16.3)
0.015
Concurrent bacteraemia
6 (30.0)
2 (4.7)
0.016
APACHE II score ≥20
15 (75.0)
16 (37.2)
0.005
Septic shock
13 (65.0)
14 (32.6)
0.015
Characteristics
Antifungal
therapy
P value
administered
before
microbiological
0.024
documentation
Data are presented as n (%).
APACHE, Acute Physiology and Chronic Health Evaluation.
4