Epidemiology and Outcomes of Candida-Associated Osteoarticular Infections: A Multicenter Retrospective Study from Turkey
Year: 2025
Type: article
Study design: Observational Study
Abstract: This multicentre retrospective study investigated the epidemiology, clinical characteristics, and fluconazole resistance rates of Candida species in osteoarticular infections across Turkey as well as the factors influencing complete recovery. Data were gathered from 73 adult patients diagnosed with proven or probable Candida-associated osteoarticular infections between 2015 and 2025 from 20 healthcare centres. The most common clinical presentation was spondylodiscitis, followed by the involvement of phalangeal bones in the hands and feet. Non-albicansCandida species accounted for 37/73 cases (50.7%), with Candida parapsilosis being the most frequent. Fluconazole resistance was low among C. albicans isolates (3%) but higher among non-albicans yeasts (27%). Bacterial co-infection, predominantly Gram-positive bacteria, was detected in 52.1% of cases. Diabetes was present in 50/73 patients (68.5%), particularly insulin-dependent diabetes, and was a prominent comorbidity that may have also contributed as a predisposing factor. Radiological detection of osteomyelitis was achieved in 69.9% of patients. Fluconazole was the most commonly used antifungal agent (74%) with a median treatment duration of 90 days. Multivariate analysis revealed that surgical debridement was significantly associated with a higher odds of clinical recovery (adjusted odds ratio [aOR], 5.764; 95% confidence interval [CI], 1.360-24.434; P = .017), whereas diabetes mellitus was significantly associated with a lower odds of total recovery (aOR, 0.205; 95% CI, 0.053-0.792; P = .022). In conclusion, this multicentre study provides epidemiological data and fluconazole resistance rates of Candida species causing osteoarticular infections in Turkey, highlights the occurrence of C. auris in this cohort, and identifies surgical intervention and diabetes mellitus as factors significantly associated with recovery.
Source: Medical Mycology
DOI: 10.1093/mmy/myaf080
Authors: Özlem Güler, Murat Üzel, Dilşat TEPE, Firdevs Aksoy, Güle Çinar, Kemal Osman Memikoğlu, Bülent Durdu, Tülay Ünver Ulusoy, Aysun Benli, Zeynep Karakaşoğlu, Neşe Saltoğlu, Derya Seyman, Işıl Deniz Aliravci, Hasibullah Yaqoobi, Ayça Aydin, Hatun Öztürk Çerik, Selin Özdemir, Betül Sümer, Azize Yetişgen, Ayşe Batirel, Ayşe Serra Özel, Seniha Şenbayrak, Yasemin T E Z E R Tekçe, Zehra Çağla Karakoç
Institutions: Kocaeli Üniversitesi, Karadeniz Technical University, Ankara University, Bezmiâlem Vakıf Üniversitesi, Ankara Etlik City Hospital, Istanbul University-Cerrahpaşa, Istanbul University, Antalya Eğitim ve Araştırma Hastanesi, Çanakkale Onsekiz Mart Üniversitesi, Başkent University, Ordu University, Izmir Bozyaka Eğitim ve Araştırma Hastanesi, Erzincan Binali Yıldırım University, Malatya Turgut Özal Üniversitesi, Turgut Özal University, Dr Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi, Sağlık Bilimleri Üniversitesi, Ümraniye Eğitim ve Araştırma Hastanesi, Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Istinye University
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,889
OpenAlex ID: W4413878639