OBJECTIVE To analyze the epidemiological characteristics of fungal infections in patients of intensive care unit (ICU) of a tertiary general hospital from 2020 to 2024 and explore the prognosis of the ICU patients with fungal sepsis and the influencing factors so as to provide guidance for optimization of prevention, control and treatment strategies for the fungal infections.

METHODS The data with regard to the isolation of 1131 strains of non-repetitive fungi from ICU patients were retrospectively collected from the Affiliated Hospital of Guizhou Medical University between 2020 and 2024. The sources of specimens and mortality rates of patients with different types of fungal infections were observed. The treatment outcomes of the patients with the infections of different sources of specimens were assessed by Kaplan-Meier survival curve and Log-rank test. The risk factors for death were screened out through univariate analysis.

RESULTS The respiratory tract specimens were the main source where the strains were isolated, accounting for 56.68%; Candida albicans was the absolute predominance, accounting for 73.47%. The mortality rate of the patients with Candida parapsilosis infection reached up to 29.17%. The mortality rate of the patients with blood infections was the highest (33.82%, P < 0.001), and the patients with the source of blood infections had the poorest prognosis (P=0.019). The echinocandins were the most commonly used for antifungal therapy, accounting for 52.05%.

CONCLUSIONS The ICU is a place where the fungal infections are highly prevalent. The high morality rate is associated with the blood source infections and specific species. It is crucial for improvement of prognosis to identify the high-risk patients in early stage and optimize the antifungal strategies.