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Construction and validation of a scoring model for pathogen characteristics and short-term prognosis risk prediction of candidemia
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Jian-Xin Ma1, Xiao-Qiang Lin1, Ming-Chi Cai1, Yu-Zhen Xu1, Jun Peng2, Sheng-Qiang Liang1, *
Medical Journal of Chinese People’s Liberation Army | 2024, 49(3) : 280 - 287
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Medical Journal of Chinese People’s Liberation Army | 2024, 49(3): 280-287
Clinical Research
Construction and validation of a scoring model for pathogen characteristics and short-term prognosis risk prediction of candidemia
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Jian-Xin Ma1, Xiao-Qiang Lin1, Ming-Chi Cai1, Yu-Zhen Xu1, Jun Peng2, Sheng-Qiang Liang1, *
Affiliations
  • 1Department of Laboratory, the 909th Hospital of Joint Logistic Support Force of PLA, Dongnan Hospital of Xiamen University, Zhangzhou, Fujian 363000, China
  • 2Department of Laboratory, Zhuzhou Hospital Affiliated to Xiangya Medical College of Central South University, Zhuzhou, Hunan 413007, China
Published: 2024-03-28 doi: 10.11855/j.issn.0577-7402.1385.2023.0626
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Objective To analyze the pathogenic characteristics and drug sensitivity of candidaemia, and construct a short-term mortality risk prediction scoring model. Methods The clinical data of patients with candidaemia admitted to the 909 Hospital of Joint Logistics Support Force from January 2011 to December 2020 were retrospectively analyzed, and the composition of pathogen composition, drug sensitivity test results and incidence of hospitalized patients were analyzed. 324 cases of candidaemia were randomly divided into modeling group (190 cases) and validation group (134 cases), and the risk factors were screened by binary logistic regression. According to the odds ratio (OR) score, the 30 day mortality risk prediction scoring model was constructed, and the predictive performance of the model was verified both in modeling and validation groups. Results 356 strains of Candida including 126 strains of C. albicans (35.39%), 79 strains of C. tropicalis (22.19%), 74 strains of C. parapsilosis (20.79%), 48 strains of C. glabrata (13.48%), 14 strains of C. guilliermondii (3.93%), 8 strains of C. krusei (2.25%), and 7 strains of other Candida (1.97%) were detected in 336 patients with candidemia. The incidence of candidaemia among hospitalized patients increased from 0.20 ‰ in 2011 to 0.48 ‰ in 2020. The resistance rate of candida to amphotericin B was significantly lower than that of fluconazole, voriconazole and itraconazole (P<0.05). Among the 324 cases included in the model, 95 patients died in 30 days after diagnosis, and the mortality rate was 29.32%. The proportion of males, fever, and parenteral nutrition in modeling group was significantly higher than that in validation group (P<0.05), while the proportion of chronic lung disease and surgical history within one month were lower than those in validation group (P<0.05). Logistic regression analysis showed that chronic renal failure, mechanical ventilation, severe neutropenia, failure to receive anti-fungal treatment within 72 hours, and APACHE Ⅱ ≥20 were risk factors for short-term death of candidaemia, the OR values were 3.179, 1.970, 2.979, 2.080, and 2.399, and the risk scores were 6, 4, 6, 4, and 5, respectively. The area under the curve (AUC) of the risk scoring model for modeling group was 0.792 (95%CI 0.721-0.862), and the result of Hosmer-Lemeshow (H-L) test was P=0.305; The AUC of validation group was 0.796 (95%CI 0.735-0.898), and the H-L test result was P=0.329. A risk score ≤8 indicated a low risk group for short-term mortality, a score of 9-15 indicated a medium risk group, and a score ≥16 indicated a high risk group. Conclusions The incidence of candidemia in hospitalized patients is increasing and the mortality is high. The risk prediction score model can effectively predict the short-term prognosis and facilitate the early identification of the prognosis.

candidaemia  /  drug sensitivity test  /  risk factors  /  prediction  /  scoring model
Jian-Xin Ma, Xiao-Qiang Lin, Ming-Chi Cai, Yu-Zhen Xu, Jun Peng, Sheng-Qiang Liang. Construction and validation of a scoring model for pathogen characteristics and short-term prognosis risk prediction of candidemia[J]. Medical Journal of Chinese People’s Liberation Army, 2024 , 49 (3) : 280 -287 . DOI: 10.11855/j.issn.0577-7402.1385.2023.0626
  • Military Equipment Scientific Research Project of PLA(JK20191A040324)
  • Science and Technology Military Support Project of Zhangzhou(ZZ2020KD04)
Year 2024 volume 49 Issue 3
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Article Info
doi: 10.11855/j.issn.0577-7402.1385.2023.0626
  • Receive Date:2022-06-21
  • Online Date:2025-11-23
  • Published:2024-03-28
Article Data
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History
  • Received:2022-06-21
  • Accepted:2022-08-28
Funding
Military Equipment Scientific Research Project of PLA(JK20191A040324)
Science and Technology Military Support Project of Zhangzhou(ZZ2020KD04)
Affiliations
    1Department of Laboratory, the 909th Hospital of Joint Logistic Support Force of PLA, Dongnan Hospital of Xiamen University, Zhangzhou, Fujian 363000, China
    2Department of Laboratory, Zhuzhou Hospital Affiliated to Xiangya Medical College of Central South University, Zhuzhou, Hunan 413007, China

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表12种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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