[Candida colonization and invasive fungal infection in hospitalized patients with hematological malignancies].

OBJECTIVE: To investigate thee status of Candida colonization and the risk factors of invasive fungal infection (IFI) in hospitalized patients with hematological malignancies. METHODS: 114 patients with hematological malignancies admitted to the hematology wards from May 2004 to April 2005 underwent fungal culture of their samples of urine, feces, and saliva once a week until the end of the sixth week of hospitalization or they were discharged. Culture of blood, sputum, or sterile body fluids were carried out when the patients were suspected to have IFI. RESULTS: 165 strains of Candida spp. were isolated from 46 of the 114 patients, C. albicans accounting for 78.8% and non-albicans Candida for 21.2% respectively. Candida was found in 38 patients (33.3%) were found to have colonization of Candida, chiefly C. albicans (76.3%). The risk factors of Candida colonization included long duration of leucopenia (WBC < 0.5 x 10(9)/L for more than 10 days) and broad-spectrum antibiotic administration. Univariate analysis showed that the risk factors of IFI included Candida colonization, long duration of leucopenia, and administration of carbapenem antibiotics, and multivariate analysis showed that long duration of leucopenia (WBC < 0.5 x 10(9)/L for more than 10 days) was the only risk factor of IFI (P = 0.015). CONCLUSION: C. albicans is still the major organism isolated from the patients with hematological malignancies. Patients with hematological malignancies have a high incidence of Candida colonization. Long duration of leucopenia is the only risk factor for IFI.