Volume 31, Number 10—October 2025
CME ACTIVITY - Research
Recent Systemic Antifungal Exposure and Nonsusceptible Candida in Hospitalized Patients, South Africa, 2012–2017
Table 2
Random-effect multivariable logistic regression analysis of the effect of prior exposure to antifungal drugs on nonsusceptible Candida bloodstream infections among patients with culture-confirmed candidemia, South Africa, 2012–2017*
Variable | <90 d of age† |
>90 days of age‡ |
|||
---|---|---|---|---|---|
Summary aOR (95% CI) for nonsusceptible Candida spp. | Wald p value | Summary aOR (95% CI) for nonsusceptible Candida spp. | Wald p value | ||
Prior antifungal exposure | |||||
No | Referent | Referent | |||
Yes |
1.06 (0.75–1.49) |
0.73 |
2.02 (1.43–2.87) |
<0.001 |
|
Age group | |||||
Neonates, <28 d | Referent | NA | |||
Young infants, 29 d–90 d | 0.79 (0.53–1.16) | 0.23 | NA | ||
Older infants, >90 d–1 y | NA | Referent | |||
Children–adolescents, >1 y–17 y | NA | 0.95 (0.58–1.56) | 0.84 | ||
Adults, 18 y–64 y | NA | 1.92 (1.26–2.91) | 0.002 | ||
Elderly, >65 y |
NA- |
2.84 (1.70–4.74) |
<0.001 |
||
Sex | |||||
F | Referent | Referent | |||
M |
1.11 (0.84–1.47) |
0.36 |
1.03 (0.81–1.32) |
0.47 |
|
Year | 0.02 | ||||
2012–2013 | Referent | Referent | |||
2014–2015 | 1.97 (1.15–3.38) | 0.01 | 1.06 (0.71–1.58) | 0.77 | |
2016 | 1.47 (0.92–2.32) | 0.1 | 1.65 (1.18–2.32) | 0.004 | |
2017 |
1.82 (1.16–2.84) |
0.009 |
1.49 (1.07–2.08) |
0.02 |
|
Province | |||||
Other | Referent | Referent | |||
Gauteng |
2.93 (1.21–7.14) |
0.01 |
1.64 (1.25–2.14) |
<0.001 |
|
ICU admission | |||||
No | NA | Referent | |||
Yes |
NA |
1.95 (1.51–2.54) |
<0.001 |
||
Healthcare sector | |||||
Private | NA | Referent | |||
Public |
NA |
0.36 (0.21–0.60) |
<0.001 |
||
Hospital stay before infection onset, d | |||||
<2 | Referent | Referent | |||
3–7 | 1.47 (0.78–2.80) | 0.24 | 0.71 (0.47–1.05) | 0.09 | |
8–14 | 1.86 (1.06–3.28) | 0.03 | 0.77 (0.53–1.13) | 0.19 | |
15–21 | 2.41 (1.33–4.39) | 0.004 | 0.79 (0.51–1.23) | 0.29 | |
>22 |
2.53 (1.38–4.64) |
0.003 |
0.98 (0.69–1.40) |
0.90 |
|
Type of delivery | |||||
Cesarean section | Referent | NA | |||
Vaginal delivery |
0.75 (0.56–1.00) |
0.05 |
NA |
||
Birthweight | 0.02 | ||||
NBW, >2,500 g | Referent | NA | |||
LBW, <2,500 g | 1.32 (0.86–2.02) | 0.21 | NA | ||
VLBW, <1,500 g | 1.49 (0.98–2.26) | 0.06 | NA | ||
ELBW, <1,000 g | 1.82 (1.11–2.97) | 0.018 | NA |
*aOR, adjusted odds ratio; ELBW, extremely low birthweight; ICU, intensive care unit; LBW, low birthweight; NA, not applicable; NBW, normal birthweight; VLBW, very low birthweight. †23 clusters, mean observations per group = 42.3 (range 1–296); intracluster correlation coefficient = 0.14; p<0.001. ‡31 clusters, mean observations per group = 42.5 (range 1–166); intracluster correlation coefficient <0.0001; p = 0.5.
Page created: August 04, 2025
Page updated: September 24, 2025
Page reviewed: September 24, 2025
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