Comparison of risk factors and mortality of candidemia by Candida auris versus Candida non-auris in intensive care units
Infectious Diseases, cilt.58, sa.1, ss.52-66, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 58 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1080/23744235.2025.2546482
- Dergi Adı: Infectious Diseases
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO)
- Sayfa Sayıları: ss.52-66
- Anahtar Kelimeler: Candida auris, candidemia, intensive care unit, mortality, risk factors
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objectives: This study aims to compare risk factors and mortality of candidemia by Candida auris versus Candida non-auris in intensive care units (ICU). Methods: A total of 437 ICU patients who developed candidemia (90 C. auris, 143 C. albicans, 204 other Candida spp.) in 2021–2023 were included. The risk factors in candidemia caused by C. auris, C. albicans and other Candida spp. were compared. Factors associated with 30-day mortality in C. auris candidemia were explored. Results: Compared to the C. albicans group, the C. auris group had more frequent ceftazidime avibactam use (OR:6.72, 95%CI: 1.29–34.98, p = 0.024) and tracheostomy (OR:4.13, 95%CI: 1.70–10.02, p = 0.002), longer colistin (OR:1.07, 95%CI: 1.01–1.13, p = 0.021) and urinary catheter use (OR:1.02, 95%CI: 1.01–1.03, p = 0.023). Compared to the other Candida spp. group, colistin use (OR:2.79, 95%CI: 1.61–4.87, p < 0.001), chronic obstructive pulmonary disease (OR:2.02, 95%CI: 1.05–3.90, p = 0.036) and concurrent bacteraemia (OR:1.92, 95%CI: 1.06–3.48, p = 0.030) were more frequent in the C. auris group. Rate of 30-day mortality was lower in C. auris patients (63.3%) compared to the C. albicans (82.5%) and other Candida spp. (75.5%) groups. While the 30-day mortality rate was higher in C. auris patients who received vasopressor therapy (OR:3.12, 95%CI: 1.78–5.47, p < 0.001) and had high lactate levels (OR:1.41, 95%CI: 1.00–1.99, p = 0.047) and low platelet counts (OR:1.00, 95%CI: 0.99–1.00, p = 0.003) on the first day of candidemia, it was lower in patients with microbiologic response (OR:0.03, 95%CI: 0.01–0.09, p < 0.001). Conclusion: The necessity of broad-spectrum antibiotics and indwelling catheters should be routinely reassessed to reduce C. auris candidemia. Lower mortality was linked to microbiologic response; thus, fungal eradication should be prioritised in clinical practice.