Evaluation of patients with candidemia monitored in the intensive care unit

In our study, it was aimed to identify the risk factors for candidemia in the ICU and to determine the variables that play a role in increasing mortality and morbidity rates in patients who developed candidemia. Our study was planned as a retrospective case-control study involving 304 patients, including 150 patients in whom Candida spp. were isolated in blood cultures and 154 patients without Candida isolation, conducted in the tertiary ICU of Eskişehir Osmangazi University Faculty of Medicine between 01.08.2020 and 29.06.2022. Patients were evaluated in terms of demographic characteristics, comorbid diseases, medical history, and additional risk factors during ICU follow-up. It was determined that the frequency of candidemia development was 5 times higher in patients who used antibiotics in the last 3 months, 5 times higher in those who stayed in nursing homes/received home healthcare services, 6 times higher in those with a history of invasive procedures in the last 30 days, and 4 times higher in patients who were hospitalized for more than 2 days in the last 12 months. In the candidemia group, the rate of Candida isolation in clinical isolates was found to be 3 times higher. The most frequently identified agent was Candida parapsilosis, followed by C. albicans. The resistance status of all Candida isolates was evaluated. In patients who resulted in death, those who did not receive appropriate antifungal treatment had a significantly longer hospital stay. The 28-day mortality rate was significantly higher in the control group compared to the candidemia group. No statistical difference was observed between the groups in terms of all-cause mortality rates at the end of the third month. In our study, candidemia was found to be associated with high mortality rates despite appropriate treatment. The reduction of mortality rates by reducing the incidence of fungal infection through the proper implementation of infection control methods can be considered an option. Key Words: Candidemia risk factors, Antifungal Resistance, Antifungal Treatment