Impact of antifungal therapy in mechanically ventilated patients with Candida spp. colonization in lower respiratory tract

Objective To explore the impact of antifungal therapy in mechanically ventilated patients with Candida spp. colonization in lower respiratory tract. Methods In this retrospective study, patients required mechanical ventilation with pulmonary Candida spp. colonization admitted into the intensive care unit (ICU) between July 2012 and June 2016 were included. The patients were divided into the treatment group and control group according to whether or not they received antifungal therapy. The isolation rate of multidrug-resistant (MDR) bacteria, the incidence of ventilator-associated pneumonia (VAP), duration of mechanical ventilation, length of ICU stay, total length of hospital stay, the 28-day mortality and the overall mortality were compared between the two groups. Results Totally, 101 patients were studied. The number of cases in treatment group was 56 and the control group was 45. The treatment group had a lower incidence of MDR bacteria isolation rate and VAP compared with the control group (16.1% vs 33.3%, 5.4% vs 17.8% respectively, both P<0.05). There were significant differences in the duration of mechanical ventilation [(17.3±5.7) days vs (22.5±7.2) days, P<0.05], length of ICU stay [(23.3±5.6) days vs (28.7 ±4.8) days, P<0.05] and the average length of hospital stay [(36.2±8.7) days vs (43.6±9.0) days, P<0.05)] in the treatment group compared with the control group. There were no statistical difference between the two groups in the 28-day mortality and the overall mortality. Conclusion Treatment of respiratory Candida spp. colonization in mechanically ventilated patients may reduce isolation rate of MDR bacteria, the incidence of VAP, duration of mechanical ventilation, length of ICU stay and total length of hospital stay. Key words: Antifungal; Candida; Respiratory tract; Mechanical ventilation; Outcomes