To investigate the clinical characteristics, pathogen distribution and infection biomarkers of patients with invasive Candida infection, and to provide theoretical basis for etiological diagnosis and treatment.

Total of 151 patients with invasive Candida infection (infection group) in the 940th Hospital of Joint Logistics Support Force of People’s Liberation Army from January 2016 to January 2021 were enrolled, retrospectively; the clinical characteristics, pathogen distribution and infection biomarkers of those patients were analyzed, while 200 patients with non-infection were collected as control group. The levels of procalcitonin (PCT), interleukin-6 (IL-6), C-reactive protein (CRP), white blood cell (WBC), neutrophil ratio (NEU%), D-dimer, 1, 3-β-D-glucan and cardiac troponin Ⅰ(CTnⅠ) of patients in infection group and control group were non-normally distributed, data were expressed by M (P25, P75), and analyzed by Mann Whitney U test.

Among the 151 patients of infection group, male/female was 1.7, the median age was (60.1 ± 18.4) years old, the fatality rate was 42.2% (49/116), the incidence rate was 42.9/10 0000/year. Among the 151 cases with invasive Candida infection, 84 cases (55.6%) were with Candida albicans infection, followed by 15 cases (9.9%) with Candida glabrata infection, 13 cases (8.6%) with Candida tropicalis and 62 cases (45.9%) with fungi and bacterial infection. The results of antimicrobial susceptibility test showed that the isolated pathogens were without acquired resistance to fluconazole, itraconazole, voriconazole, 5-fluorocytosine and amphotericin. The main sources of specimens were blood [38 cases (25.2%)], ascites [37 cases (24.5%)] and abdominal drainage fluid [23 cases (15.2%)]. The inpatient departments were dominated in ICU [59 cases (39.1%)], followed by department of general surgery [22 cases (14.6%)] and department of hepatobiliary surgery [18 cases (11.9%)]. The main clinical diagnosis were 32 kinds of common diseases, including sepsis [18 cases (11.9%)], intestinal perforation [15 cases (9.9%)], abdominal infection [11 cases (7.3%)], cholangiocarcinoma [11 cases (7.3%)] and hematological diseases [11 cases (7.3%)], etc. The positive rate of serum 1, 3-β-D-glucan accounted for 66.7% (56/84) of patients with invasive Candida infection, with the level of 266.1 (167.0, 286.0) pg/ml. The positive rate of CTnⅠ accounted for 19.9% (30/151), with the level of 0.35 (0.05, 0.24) μg/L. Compared with the control group, PCT, IL-6, CRP, WBC, NEU% and D-dimer were all significantly different of patients in infection group (Z = 10.70, 6.33, 7.27, 8.50, 11.74, 8.01; all P < 0.001).

Patients with invasive Candida infection were with critical condition and high mortality, Candida albicans was the main pathogen. Patients were mainly found with bloodstream infection and abdominal infection. CTnⅠ increased in some patients with invasive Candida infection.