Year: 2026
Type: article
Study design: Observational Study
Abstract: Candida species cause life-threatening bloodstream infections, particularly in critically ill and immunocompromised patients. Although guideline adherence has been shown to improve outcomes, real-world implementation is often constrained. This cross-sectional, web-based survey evaluated current clinical practices and barriers in candidemia management across German healthcare institutions. A structured questionnaire based on the EQUAL Candida score was disseminated online from 10/2023 to 07/2025. Physicians involved in candidemia management reported institutional characteristics, diagnostic practices, antifungal treatment strategies, central line management, and follow-up practices. Data were analyzed using descriptive statistics and chi-square testing. A total of 217 physicians from 147 institutions participated, with 74.5% of participants affiliated with large care facilities. Caspofungin was the predominant first-line therapy (81.4%), whereas fluconazole was used by 5.3% of participants. First-line choice did not differ by years of clinical experience (P = 0.194). Echocardiography was routinely performed by 57% of participants; selective use showed no association with years of clinical experience (P = 0.845) or annual number of candidemia cases (P = 0.089). Ophthalmoscopy was performed routinely by 37% of participants and showed no association with experience (P = 0.907), but was significantly associated with lower annual caseload (P = 0.02) and infectious disease speciality (P = 0.003). Central line removal or replacement within 24 h was reported by 82.5%. Follow-up blood cultures were obtained daily by 31.4%, while 54.8% repeated cultures every 48 h. While core candidemia management practices are generally well implemented in German healthcare institutions, certain recommended diagnostic steps remain underutilized. Targeted educational and structural interventions are needed to strengthen guideline adherence and optimize patient outcomes across diverse settings.
Source: Medical Mycology
DOI: 10.1093/mmy/myag038
Authors: Ilana Reinhold, Jon Salmanton-García, Janina Leckler, Jannik Stemler, Albert Wahl, Oliver A Cornely, Danila Seidel, Rosanne Sprute, the CAMEO collaborator group, Thomas Abele, Rehsan Akdas, Parviz Aliyev, Christoph Ammer-Herrmenau, Tobias Manuel Appel, Christina Bähr, Christina Bahrs, Rudolf Baloun, Sören L Becker, Christine Becket, Reinhard Berner, Gernot Beutel, Christian Beyer, Karla Boos, Stefan Borgmann, Hendrik Bracht, Sven Breitschwerdt, Sarina K Butzer, Evgeniya Chasovnikova, Maximilian Christopeit, Katrin Dannenberg, Muhannad Darkazanli, Sebastian Dolff, Rika Draenert, Christian Eckmann, Stefan Ehrentraut, Rudolf Eicker, Alexandra Esser-Budde, Julia Eßer, Torben Esser, Till Esslinger, Jannik Fasse, Julia Fischer, Laura Fischer, Anette Friedrichs, Andre Fuchs, Kristina Fuest, Bahman Gharavi, Christian Giesa, Nicola Giesen, Clemens Giessen-Jung, Matthias Grade, Daniel Grimm, Andreas H Groll, Pia Hartmann, Jürgen Held, Fränze Helming, Larissa Henze, Lukas Herrmann, Anke Hildebrandt, Patricia Horn, André Jakob, Johanna Jank, Björn Jensen, Oana Joean, Anna Philine Karl, Meinolf Karthaus, Antonios Katsounas, Nils Kellner, Elham Khatamzas, Michael Kiehl, Heike Kneifel, Kay-Karsten Kober, Cathrin Kodde, Anna Köster, Lampros Kousoulad, Oliver Kriege, William Krüger, Wolfgang Kruger, Christian Lanckohr, Lukas Matthias Langner, Johannes Liese, Judith Lindert, Luise Martin, Gregor Massoth, Lisa Meinker, Michal Moser, Gesa-Henrike Nawrot, André Oberthür, Wilfried Obst, Mark Oette, Ioana Diana Olaru, Ulrich Pecks, Mathias Pletz, Jens M Poth, Dominic Preuß, Jan Ramming, Peter-Michael Rath, Maike Rebenstorff, Sabine Recknagel-Friese, Thomas Reichel, Constantin B Rohsbach, Felix Rosendahl, Melanie Sasse, Stephanie Sasse, Christopher Sauer, Kerstin Schäfer-Eckart, Enrico Schalk, Michael Schmid, Martin Schmidt-Hieber, Volker Schmitz, Viktoria Schneitler, Andreas Schönfeld, Jana Schroeder, Ulrich Schulz- von Gaudecker, Christina Schulze, Marco H Schulze, Sofie Schumacher, Georg C Schwabe, Hortense Slevogt, Urte Sommerwerck, Karsten Spiekermann, Raphael Stauf, Miriam Stegemann, Natyra Tahiri, Phil-Robin Tepasse, Marcus Thomé, Roman Tilly, Daniela Tominski, Xavier Tonnar, Janina Trauth, Anna Teresa Tremmel, Maria Vehreschild, Bianca Vogel, Amrei von Braun, Jakob von Herder, Susanne Weber, Tobias Weiglein, Matthias Welsner, Janina Soler Wenglein, Werner Wenzel, Irene Wolff, Frank Ziemann, Michael Zoller, Anna Zormpa
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,889
Funder: Mundipharma Research Limited
Award: G8634024855
OpenAlex ID: W7155158373