Fig. 1
Univariate and multiple binary logistic regression analysis in identifying candidemia in Covid-19 patients_
| Variable | Univariate | Multiple | ||
|---|---|---|---|---|
| OR (95% CI) | p | OR (95% CI) | p | |
| Gender (female/male) | 2.17 (1.07–4.41) | 0.032 | – | – |
| Age (year) | 1.01 (0.99–1.04) | 0.269 | – | – |
| APACHE II score | 0.97 (0.93–1.02) | 0.181 | – | – |
| SOFA score | 0.93 (0.83–1.05) | 0.224 | – | – |
| Hospital stay (day) | 1.04 (1.02–1.07) | 0.002 | – | – |
| ICU stay (day) | 1.05 (1.02–1.09) | 0.002 | 1.06 (1.01–1.11) | 0.025 |
| Comorbidities | 5.70 (2.55–12.74) | < 0.001 | 6.94 (2.01–23.90) | 0.002 |
| DM | 1.07 (0.50–2.28) | 0.858 | – | – |
| HT | 1.47 (0.71–3.05) | 0.299 | – | – |
| COPD | 3.94 (1.08–14.43) | 0.039 | – | – |
| CAD | 2.56 (1.05–6.25) | 0.039 | – | – |
| Goitre | 4.67 (0.55–39.89) | 0.159 | – | – |
| Neurological disease | 4.52 (0.96–21.24) | 0.056 | – | – |
| CKF/AKF | 1.86 (0.67–5.18) | 0.235 | – | – |
| Intubation | 2.90 (1.43–5.88) | 0.003 | – | – |
| Central Catheter | 8.33 (3.36–20.65) | < 0.001 | – | – |
| BSA | 93.75 (25.09–350.24) | < 0.001 | 90.68 (21.84–376.53) | < 0.001 |
| Corticosteroid | 4.73 (2.24–9.99) | < 0.001 | – | – |
Antifungal results against Candida species, reproduced in blood_
| VRC μg/ml | FLC μg/ml | CAS μg/ml | AMB μg/ml | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Species | GM | MIC50 | MIC90 | GM | MIC50 | MIC90 | GM | MIC50 | MIC90 | GM | MIC50 | MIC90 |
| C. albicans (n = 42) | 0.42 | 0.25 | 0.75 | 2.42 | 2 | 4 | 0.74 | 0.75 | 1 | 0.59 | 0.25 | 1.5 |
| C. parapsilosis (n = 13) | 0.39 | 0.25 | 0.5 | 4.07 | 4 | 8 | 1.46 | 1 | 2 | 0.84 | 0.75 | 1.5 |
| C. glabrata (n = 7) | 0.42 | 0.47 | 0.5 | 22.5 | 16 | 48 | 1.02 | 1.5 | 1.5 | 0.53 | 0.5 | 0.75 |
| C. tropicalis (n = 9) | 0.35 | 0.38 | 0.5 | 3.22 | 2 | 4 | 0.75 | 0.5 | 2 | 0.91 | 0.38 | 2 |
| C. krusei (n = 3) | 0.21 | 0.25 | 0.38 | 74.6 | 64 | 128 | 0.75 | 0.75 | 1 | 0.59 | 0.75 | 1 |
Comparison of the demographic and clinical characteristics among the study groups_
| Variable | Groups | p† | ||
|---|---|---|---|---|
| Group 1 (n = 78) | Group 2 (n = 189) | Group 3 (n = 57) | ||
| Gender (male) | 54 (69.2)a | 87 (46)b | 29 (50.9)b | 0.002 |
| Age (year) | 71.33 ± 13.67ab | 73.42 ± 11.34a | 68.51 ± 15.74b | 0.035 |
| APACHE II score | 12 (7–19) | 12 (7–19) | 14 (9–19) | 0.485 |
| SOFA score | 4 (2–6) | 4 (2–6) | 4 (3–6) | 0.334 |
| Hospital stay (day) | 27 (18–43)a | 22 (15–32)b | 18 (13–26)b | < 0.001 |
| ICU stay (day) | 19 (10–27)a | 14 (8–22)ab | 10 (7–15)b | < 0.001 |
| PCR (positive) | 50 (64.1) | 128 (67.7) | 36(63.1) | 0.889 |
| Comorbidities | 66 (84.6)a | 162 (85.7)a | 28(49.1)b | < 0.001 |
| DM | 23 (29.4) | 70 (37) | 16(28) | 0.305 |
| HT | 30 (38.4)ab | 97( 49.7)a | 17 (29.8)b | 0.008 |
| COPD | 14 (17.9)a | 35 (18.5)a | 3 (5.2)b | 0.049 |
| CAD | 23 (29.4) | 40 (21.1) | 8 (14) | 0.093 |
| Malignancy | 10 (12.8)a | 15 (7.9)a | 0 (0.0)b | 0.022 |
| Goitre | 6 (7.7)a | 2 (1.0)b | 1 (1.7)ab | 0.010 |
| Kidney transplantation | 0 (0.0) | 2 (1.0) | 0 (0.0) | 0.487 |
| Immunological disease | 3 (3.8) | 2(1.0) | 0 (0.0) | 0.142 |
| Neurological disease | 13 (16.6)a | 30 (15.8)a | 2 (3.5)b | 0.044 |
| CKF/AKF | 14 (17.9) | 26 (13.7) | 6 (10.5) | 0.226 |
| Mortality | 54 (69.2) | 133 (60.4) | 33 (57.8) | 0.208 |
| Intubation | 49 (62.8)a | 107 (85.2)a | 21 (36.8)b | 0.008 |
| Central Catheter | 42 (53.9)a | 58 (30.7)b | 7 (12.2)c | < 0.001 |
| Juguler | 13 (30.9) | 18 (31.0) | 4 (57.1) | 0.139 |
| Femoral | 23 (54.7) | 31 (53.4) | 2 (28.5) | < 0.001 |
| Dialysis | 6 (14.2) | 9 (15.5) | 1 (14.2) | 0.286 |
| BSA | 75 (96.1)a | 178 (94.1)a | 12 (21.0)b | < 0.001 |
| Corticosteroid | 49 (62.8)a | 142 (75.1)b | 15 (26.3)c | < 0.001 |
| IL-6 receptor inhibitors | 7 (9.0) | 7 (3.7) | 3 (5.2) | 0.214 |
| TPN | 24 (30.8)a | 59 (31.2)a | 5 (8.7)b | 0.003 |
| AF | 34 (43.5) | 95 (50.2) | – | 0.192 |
| AF+/mortality | 20 (58.8) | 56 (58.9) | – | 0.511 |
| AF–/mortality | 34 (77.2) | 76 (80.8) | – | 0.803 |
| p‡ | 0.080 | < 0.001 | ||
Candida species distribution and frequency of antifungal use in the study groups_
| Total | FLC | CAS | ANI | MIC | AMB | |
|---|---|---|---|---|---|---|
| Group 1 | ||||||
| n | 78 | 12 | 11 | 3 | 3 | 5 |
| C. albicans | 43 (55.1) | 6 (50.0) | 5 (45.5) | 0 (0.0) | 1 (33.3) | 3 (60.0) |
| C. dubliniensi | 1 (1.3) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| C. glabrata | 7 (9.0) | 1 (8.3) | 1 (9.1) | 1 (33.3) | 0 (0.0) | 0 (0.0) |
| C. krusei | 3 (3.8) | 1 (8.3) | 0 (0.0) | 0 (0.0) | 2 (66.7) | 1 (20.0) |
| C. lusitaniae | 1 (1.3) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| C. parapsilosis | 14 (17.9) | 3 (25.0) | 3 (27.3) | 1 (33.3) | 0 (0.0) | 0 (0.0) |
| C. tropicalis | 9 (11.5) | 1 (8.3) | 2 (18.2) | 1 (33.3) | 0 (0.0) | 1 (20.0) |
| Group 2 | ||||||
| n | 189 | 46 | 32 | 9 | 4 | 4 |
| C. albicans | 123 (65.1) | 34 (73.9) | 22 (68.8) | 7 (77.8) | 3 (75.0) | 0 (0.0) |
| C. glabrata | 9 (4.7) | 1 (2.2) | 1 (3.1) | 1 (11.1) | 1 (25.0) | 1 (25.0) |
| C. kefyr | 2 (1.1) | 2 (4.3) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (25.0) |
| C. krusei | 2 (1.1) | 0 (0.0) | 1 (3.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| C. lusitaniae | 1 (0.5) | 0 (0.0) | 1 (3.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| C. parapsilosis | 29 (15.3) | 4 (8.7) | 3 (9.4) | 0 (0.0) | 0 (0.0) | 1 (25.0) |
| C. tropicalis | 22 (11.6) | 5 (10.9) | 4 (12.5) | 1 (11.1) | 0 (0.0) | 1 (25.0) |
| Group 4 (53.8% of candidemia) | ||||||
| n | 42 | 9 | 6 | 1 | 0 | 3 |
| C. albicans | 26 (61.9) | 5 (55.6) | 4 (66.7) | 0 (0.0) | 0 (0.0) | 3 (100.0) |
| C. parapsilosis | 10 (23.8) | 3 (33.3) | 2 (33.3) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| C. glabrata | 1 (2.4) | 0 (0.0) | 0 (0.0) | 1 (100.0) | 0 (0.0) | 0 (0.0) |
| C. tropicalis | 3 (7.1) | 1 (11.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| C. krusei | 1 (2.4) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| C. duplensie | 1 (2.4) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |