Work

Candidemia in the intensive care unit before and during the COVID-19 pandemic: a cross-sectional analysis

Year: 2025

Type: article

Abstract: • Despite reports on increased incidences of candidemia among ICU patients during the COVID-19 period, the present study found lower incidences both during the COVID-19 period and among COVID-19 patients. • The number of blood cultures collected during the two periods was a bit lower during the pandemic (2.8 cultures vs. 2.3 cultures per patient). • During the pandemic, fluconazole resistance was lower, as was the resistance rate of C. parapsilosis . Increased incidences of candidemia have been reported among ICU patients during the coronavirus disease 2019 (COVID-19) pandemic. The study included adult patients diagnosed with candidemia at ICU during two periods from January 1, 2017, to December 31, 2022, separated by the in-country declaration of COVID-19. We evaluated the incidences of candidemia during two periods marked by transformation of an old tertiary hospital into a completely new and modern facility, which took place just before the emergence of the pandemic. During the pre-COVID-19 and COVID-19 periods, 3,796 and 10,467 patients were admitted to the ICU, of whom 61 (1.6%, incidence 2.03 per 1,000-ICU days) and 62 (0.6%, incidence 0.66 per 1,000-ICU days) patients developed candidemia, respectively. The median time to candidemia detection was significantly longer in the COVID-19 period (34 vs 29 days, p=0.022). During the pre-COVID-19 period, C. parapsilosis (68.9% vs 37.1%) was the most predominant species, which was superseded during the COVID-19 period by C. albicans (35.5% vs 16.4%). Fluconazole resistance was significantly lower in the COVID-19 period (14.5% vs 31.1%, p=0.027), with a lower resistance rate of C. parapsilosis (21.7% vs 38.1%). Of 3,094 (29.6%) patients with COVID-19, candidemia developed in nine patients (0.03%) as compared with 53 patients (0.72%) without COVID-19. Despite reports on increased incidences of candidemia among ICU patients during the COVID-19 period, lower incidences of candidemia found in the present study both during the COVID-19 period and among COVID-19 patients may be attributed to the complete transformation of our facility.

Source: IJID Regions

DOI: 10.1016/j.ijregi.2025.100807

Authors: Suzan Şahin, Elif Bombacı, Bülent Kaya, Serap Demir Tekol

Institution: Dr Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi

Language: English

Topic: Antifungal resistance and susceptibility

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,380