ORIGINAL RESEARCH article
Front. Microbiol.
Sec. Infectious Agents and Disease
Volume 16 - 2025 | doi: 10.3389/fmicb.2025.1630226
Epidemiology Risk Factors and Antifungal Resistance Patterns of Candida in Cancer Patients in Jiangxi China
Provisionally accepted
Hazrat Bilal1
Xiaohui Li1Xunsong Wang1
Muhammad Nadeem Khan2
Muhammad Shafiq2Jiamei yu1Hanman Qiu1
Qiaoli Lv1*Bin Xu1*- 1Jiangxi Cancer Hospital, Nanchang, China
- 2Shantou University Medical College, Shanatou, China
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Background: Candidiasis in cancer patients remains largely unexplored in China. This study examines risk factors and antifungal susceptibility patterns of Candida in cancer patients from Jiangxi, China.Methods: Clinical and demographic data on Candida in cancer patients (2018)(2019)(2020)(2021)(2022)(2023)(2024) were retrospectively collected at Jiangxi Cancer Hospital, Nanchang, China. Candida distribution across cancers and antifungal susceptibility patterns were analyzed. Risk factors were identified via logistic regression, and antifungal consumption was correlated with Candida distribution. Survival probabilities were compared between patients with C. albicans and those with non-albicans Candida (NAC) infections.. Results: Among 2761 Candida isolates, 1703 (61.68%) were C. albicans and 1058 (38.31%) were NAC, with a year-wise trend showing a decline in C. albicans and a rise in NAC. C. albicans was significantly higher in lung (40.57%) and nasopharyngeal (11.33%) cancers, while NAC were more common in gastric (7.56%), colon (8.69%), and urogenital (14.65%) cancers. NAC risk factors included inappropriate empirical therapy (OR 13.8, P<0.001), hypoproteinemia (OR 1.35), anemia (OR 1.28), urinary tract infection (OR 1.71), and indwelling catheters (OR 1.27) (all P<0.05).Radiotherapy, targeted therapy, glucocorticoids, chest tube insertion, and parenteral nutrition were associated with C. albicans (P≤0.01). Amphotericin B (>99%) and echinocandins (>96%) showed the highest efficacy. C. tropicalis displayed notable azole resistance (40.9-74.45%). Caspofungin use negatively correlated with C. albicans (r= -0.84, P=0.02) and positively with C. tropicalis (r=0.78, P=0.04) and N. glabrata (r=0.85, p=0.02). NAC infections showed 1.5-fold higher mortality rate than C. albicans (95% CI: 1.1-2.0; P=0.0075).These findings may aid healthcare officials in improving Candida management in the region and similar settings.
Keywords: Candida species, cancer patients, antifungal resistance, Antifungal consumption, Epidemiology and risk factors
Received: 17 May 2025; Accepted: 11 Jul 2025.
Copyright: © 2025 Bilal, Li, Wang, Khan, Shafiq, yu, Qiu, Lv and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Qiaoli Lv, Jiangxi Cancer Hospital, Nanchang, China
Bin Xu, Jiangxi Cancer Hospital, Nanchang, China
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