Xianlian Chen-Data

Candidemia poses a substantial global health threat due to its high mortality. This study analyzed 133 candidemia cases from a tertiary hospital in Guizhou, China, to assess clinical characteristics, species distribution, antifungal susceptibility, and molecular epidemiology. Non-albicans Candida (NAC) species predominated (52.6%) over C. albicans (47.4%), with an overall 30-day mortality of 48.1%. C. albicans-infected patients had higher mortality, where hypoalbuminemia and septic shock were independent risk factors, while antifungal therapy and higher platelet counts were protective. In NAC infections, septic shock and elevated serum urea predicted mortality. Prognostic biomarkers differed: D-dimer and C-reactive protein for C. albicans, versus urea and total bilirubin for NAC. Most isolates remained susceptible to antifungals, but C. glabrata and C. tropicalis exhibited increased azole resistance. Multilocus sequence typing of 48 C. albicans isolates identified 37 genotypes (62.2% novel), with two novel clonal complexes (CC138and CC139) forming a distinct Chinese cluster. These findings enhance understanding of candidemia management, resistance patterns, and molecular epidemiology, aiding in optimized treatment and infection control strategies.