Epidemiology and risk factors of fungal pathogens in sepsis: a prospective nationwide multicenter cohort study
Abstract Background The incidence of sepsis with identified fungal pathogens is increasing and is associated with higher morbidity and mortality. Co-infection with fungal infections in COVID-19 patients is attracting clinical attention. This study examines the epidemiology, risk factors, and outcome...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-03-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-025-10722-y |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849774511114682368 |
|---|---|
| author | Jeong Eun Lee Da Hyun Kang Hyekyeong Ju Dong Kyu Oh Su Yeon Lee Mi Hyeon Park Chae-Man Lim Song I Lee On behalf of the Korean sepsis Alliance (KSA) investigators |
| author_facet | Jeong Eun Lee Da Hyun Kang Hyekyeong Ju Dong Kyu Oh Su Yeon Lee Mi Hyeon Park Chae-Man Lim Song I Lee On behalf of the Korean sepsis Alliance (KSA) investigators |
| author_sort | Jeong Eun Lee |
| collection | DOAJ |
| description | Abstract Background The incidence of sepsis with identified fungal pathogens is increasing and is associated with higher morbidity and mortality. Co-infection with fungal infections in COVID-19 patients is attracting clinical attention. This study examines the epidemiology, risk factors, and outcomes among sepsis patients with identified fungal pathogens. Methods We conducted a nationwide cohort study of adult patients with sepsis from the Korean Sepsis Alliance Database in South Korea between September 2019 and December 2021. We identified 407 patients with documented fungal pathogens, categorized according to the presence of hemato-oncologic malignancies. Results Of the 11,981 patients with sepsis, fungal pathogens were identified in 3.4% of cases. Among these patients, 38.3% had co-existing hematologic or solid organ cancer. Older age, higher clinical frailty scale scores, and underlying conditions, such as chronic kidney disease, cerebrovascular disease, and dementia, were more prevalent in patients without hemato-oncologic malignancies. The most common fungal pathogens were Candida albicans (47.9%), Candida glabrata (20.6%), and Candida tropicalis (13.5%). Only 6.6% of the patients with confirmed fungal pathogens received antifungal treatment. The presence of hemato-oncologic malignancies did not significantly affect patient outcomes. Factors associated with the presence of identified fungal pathogens included chronic kidney disease (Odds ratio [OR] 1.662; 95% confidence interval [CI] 1.216–2.273; p = 0.001), connective tissue disease (OR 1.885; 95% CI 1.058–3.358; p = 0.032), immunocompromised status (OR 2.284; 95% CI 2.186–3.753; p = 0.001), and invasive mechanical ventilation (OR 2.864; 95% CI 2.186–3.753; p < 0.001). Conclusions Sepsis identified fungal pathogen are associated with chronic kidney disease, immunocompromised status and other risk factors, demonstrating the need for early detection, targeted management and improved antifungal strategies to improve patient outcomes. |
| format | Article |
| id | doaj-art-27e13826071849d48c8b81f017ec1650 |
| institution | DOAJ |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-27e13826071849d48c8b81f017ec16502025-08-20T03:01:41ZengBMCBMC Infectious Diseases1471-23342025-03-0125111010.1186/s12879-025-10722-yEpidemiology and risk factors of fungal pathogens in sepsis: a prospective nationwide multicenter cohort studyJeong Eun Lee0Da Hyun Kang1Hyekyeong Ju2Dong Kyu Oh3Su Yeon Lee4Mi Hyeon Park5Chae-Man Lim6Song I Lee7On behalf of the Korean sepsis Alliance (KSA) investigatorsDivision of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of MedicineDivision of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of MedicineDivision of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of MedicineDepartment of Pulmonary and Critical Care Medicine, Dongkang Medical CenterDepartment of Pulmonary and Critical Care Medicine, Asan Medical CenterDepartment of Pulmonary and Critical Care Medicine, Asan Medical CenterDepartment of Pulmonary and Critical Care Medicine, Asan Medical CenterDivision of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of MedicineAbstract Background The incidence of sepsis with identified fungal pathogens is increasing and is associated with higher morbidity and mortality. Co-infection with fungal infections in COVID-19 patients is attracting clinical attention. This study examines the epidemiology, risk factors, and outcomes among sepsis patients with identified fungal pathogens. Methods We conducted a nationwide cohort study of adult patients with sepsis from the Korean Sepsis Alliance Database in South Korea between September 2019 and December 2021. We identified 407 patients with documented fungal pathogens, categorized according to the presence of hemato-oncologic malignancies. Results Of the 11,981 patients with sepsis, fungal pathogens were identified in 3.4% of cases. Among these patients, 38.3% had co-existing hematologic or solid organ cancer. Older age, higher clinical frailty scale scores, and underlying conditions, such as chronic kidney disease, cerebrovascular disease, and dementia, were more prevalent in patients without hemato-oncologic malignancies. The most common fungal pathogens were Candida albicans (47.9%), Candida glabrata (20.6%), and Candida tropicalis (13.5%). Only 6.6% of the patients with confirmed fungal pathogens received antifungal treatment. The presence of hemato-oncologic malignancies did not significantly affect patient outcomes. Factors associated with the presence of identified fungal pathogens included chronic kidney disease (Odds ratio [OR] 1.662; 95% confidence interval [CI] 1.216–2.273; p = 0.001), connective tissue disease (OR 1.885; 95% CI 1.058–3.358; p = 0.032), immunocompromised status (OR 2.284; 95% CI 2.186–3.753; p = 0.001), and invasive mechanical ventilation (OR 2.864; 95% CI 2.186–3.753; p < 0.001). Conclusions Sepsis identified fungal pathogen are associated with chronic kidney disease, immunocompromised status and other risk factors, demonstrating the need for early detection, targeted management and improved antifungal strategies to improve patient outcomes.https://doi.org/10.1186/s12879-025-10722-yDiseaseFungusEpidemiologySepsis |
| spellingShingle | Jeong Eun Lee Da Hyun Kang Hyekyeong Ju Dong Kyu Oh Su Yeon Lee Mi Hyeon Park Chae-Man Lim Song I Lee On behalf of the Korean sepsis Alliance (KSA) investigators Epidemiology and risk factors of fungal pathogens in sepsis: a prospective nationwide multicenter cohort study BMC Infectious Diseases Disease Fungus Epidemiology Sepsis |
| title | Epidemiology and risk factors of fungal pathogens in sepsis: a prospective nationwide multicenter cohort study |
| title_full | Epidemiology and risk factors of fungal pathogens in sepsis: a prospective nationwide multicenter cohort study |
| title_fullStr | Epidemiology and risk factors of fungal pathogens in sepsis: a prospective nationwide multicenter cohort study |
| title_full_unstemmed | Epidemiology and risk factors of fungal pathogens in sepsis: a prospective nationwide multicenter cohort study |
| title_short | Epidemiology and risk factors of fungal pathogens in sepsis: a prospective nationwide multicenter cohort study |
| title_sort | epidemiology and risk factors of fungal pathogens in sepsis a prospective nationwide multicenter cohort study |
| topic | Disease Fungus Epidemiology Sepsis |
| url | https://doi.org/10.1186/s12879-025-10722-y |
| work_keys_str_mv | AT jeongeunlee epidemiologyandriskfactorsoffungalpathogensinsepsisaprospectivenationwidemulticentercohortstudy AT dahyunkang epidemiologyandriskfactorsoffungalpathogensinsepsisaprospectivenationwidemulticentercohortstudy AT hyekyeongju epidemiologyandriskfactorsoffungalpathogensinsepsisaprospectivenationwidemulticentercohortstudy AT dongkyuoh epidemiologyandriskfactorsoffungalpathogensinsepsisaprospectivenationwidemulticentercohortstudy AT suyeonlee epidemiologyandriskfactorsoffungalpathogensinsepsisaprospectivenationwidemulticentercohortstudy AT mihyeonpark epidemiologyandriskfactorsoffungalpathogensinsepsisaprospectivenationwidemulticentercohortstudy AT chaemanlim epidemiologyandriskfactorsoffungalpathogensinsepsisaprospectivenationwidemulticentercohortstudy AT songilee epidemiologyandriskfactorsoffungalpathogensinsepsisaprospectivenationwidemulticentercohortstudy AT onbehalfofthekoreansepsisallianceksainvestigators epidemiologyandriskfactorsoffungalpathogensinsepsisaprospectivenationwidemulticentercohortstudy |