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已发表论文
北京地区 5 年回顾性研究：念珠菌尿路感染的菌种分布、耐药性及危险因素
Authors Cao X, Liu J, Sun T, Duan F, Song N, Liu Z, Song L, Yang X, Zhang W, Wang Y
Received 21 July 2025
Accepted for publication 4 November 2025
Published 12 November 2025 Volume 2025:18 Pages 5917—5926
DOI https://doi.org/10.2147/IDR.S555207
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Héctor Mora-Montes
Xueping Cao,* Jia Liu,* Tao Sun,* Feifei Duan, Na Song, Zhaoyang Liu, Lijie Song, Xiaoli Yang, Wei Zhang, Yufei Wang
Department of Clinical Laboratory, The Third Medical Center, PLA General Hospital, Beijing, 100039, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yufei Wang, Department of Clinical Laboratory, The Third Medical Center, PLA General Hospital, Beijing, 100039, People’s Republic of China, Email tosya@163.com Wei Zhang, Department of Clinical Laboratory, The Third Medical Center, PLA General Hospital, Beijing, 100039, People’s Republic of China, Email 13521992518@163.com
Objective: The Candida genus has become an important pathogen of urinary tract infections (UTIs). Systemic infections caused by Candida could result in high mortality and significant medical costs, presenting an increasingly severe clinical challenge. This five-year retrospective study was designed to investigate the species distribution, antifungal resistance patterns and clinical risk factors associated with Candida urinary tract infections, it is critical to guide the rational selection of antifungal agents and optimize clinical management strategies.
Methods: This retrospective study analyzed 229 cases of Candida UTIs diagnosed at the Third Medical Center of the Chinese PLA General Hospital between 2020 and 2024. Species distribution and antifungal susceptibility were evaluated using chi-square tests, while multivariate logistic regression was employed to identify independent risk factors.
Results: 1. A total of 230 Candida strains were isolated from 229 patients (138 males and 91 females). The detection rate of C. albicans decreased from 47.06% in 2020 to 39.22% in 2024, with a corresponding rise in non-albicans species.2. Among the 199 strains tested for antifungal susceptibility, all isolates remained fully susceptible to amphotericin B and 5-fluorocytosine (0.00% resistance). In contrast, resistance to azole antifungals was notably higher. C. tropicalis exhibited significantly greater resistance to triazole agents compared to C. albicans (P< 0.05), while C. glabrata demonstrated a high resistance rate to itraconazole (44.00%), indicating a growing resistance concern. 3. Univariate analysis showed that hospital stays ≥ 14 days, urinary catheterization ≥ 7 days, and broad-spectrum antibiotic use were significantly associated with Candida UTIs (P< 0.05). Multivariate logistic regression identified prolonged hospitalization and catheterization as independent risk factors (P< 0.05).
Conclusion: The increasing prevalence of non-Candida albicans species and rising azole resistance—particularly among Candida tropicalis—underscore the importance of routine species identification and antifungal susceptibility testing. Early urine culture screening and individualized antifungal selection are crucial, especially for patients with prolonged hospital stays or indwelling catheters, promoting the transition from empirical medication use to individualized treatment in clinical practice.
Keywords: urinary tract infections, Candida, antifungal resistance, risk factors
Department of Clinical Laboratory, The Third Medical Center, PLA General Hospital, Beijing, 100039, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yufei Wang, Department of Clinical Laboratory, The Third Medical Center, PLA General Hospital, Beijing, 100039, People’s Republic of China, Email tosya@163.com Wei Zhang, Department of Clinical Laboratory, The Third Medical Center, PLA General Hospital, Beijing, 100039, People’s Republic of China, Email 13521992518@163.com
Objective: The Candida genus has become an important pathogen of urinary tract infections (UTIs). Systemic infections caused by Candida could result in high mortality and significant medical costs, presenting an increasingly severe clinical challenge. This five-year retrospective study was designed to investigate the species distribution, antifungal resistance patterns and clinical risk factors associated with Candida urinary tract infections, it is critical to guide the rational selection of antifungal agents and optimize clinical management strategies.
Methods: This retrospective study analyzed 229 cases of Candida UTIs diagnosed at the Third Medical Center of the Chinese PLA General Hospital between 2020 and 2024. Species distribution and antifungal susceptibility were evaluated using chi-square tests, while multivariate logistic regression was employed to identify independent risk factors.
Results: 1. A total of 230 Candida strains were isolated from 229 patients (138 males and 91 females). The detection rate of C. albicans decreased from 47.06% in 2020 to 39.22% in 2024, with a corresponding rise in non-albicans species.2. Among the 199 strains tested for antifungal susceptibility, all isolates remained fully susceptible to amphotericin B and 5-fluorocytosine (0.00% resistance). In contrast, resistance to azole antifungals was notably higher. C. tropicalis exhibited significantly greater resistance to triazole agents compared to C. albicans (P< 0.05), while C. glabrata demonstrated a high resistance rate to itraconazole (44.00%), indicating a growing resistance concern. 3. Univariate analysis showed that hospital stays ≥ 14 days, urinary catheterization ≥ 7 days, and broad-spectrum antibiotic use were significantly associated with Candida UTIs (P< 0.05). Multivariate logistic regression identified prolonged hospitalization and catheterization as independent risk factors (P< 0.05).
Conclusion: The increasing prevalence of non-Candida albicans species and rising azole resistance—particularly among Candida tropicalis—underscore the importance of routine species identification and antifungal susceptibility testing. Early urine culture screening and individualized antifungal selection are crucial, especially for patients with prolonged hospital stays or indwelling catheters, promoting the transition from empirical medication use to individualized treatment in clinical practice.
Keywords: urinary tract infections, Candida, antifungal resistance, risk factors