Candida colonization in mechanically ventilated patients

The diagnosis of pulmonary candidosis is controversial. We undertook a prospective study on 50 mechanically ventilated (>48 h) patients who were hospitalized (>72 h) in the intensive care unit (ICU) with the aim of assessing the incidence of the isolation of Candida species from endotracheal aspirates (EA). Patients were categorized as individuals already colonized with Candida spp. on admission, individuals becoming colonized during hospitalization, or patients with no colonization. Patients in the ICU were hospitalized for a mean of 23 days. The percentage of patients already colonized with Candida was low (six of 50; 12%), the incidence of Candida isolation from EA in critically ill, mechanically ventilated patients in ICU was also low (six of 50; 12%). Age, duration of hospitalization, pre-treatment with antimicrobials or immunosuppressive agents and occurrence of underlying disease were not risk factors in our study. Both antifungal usage and neutropenia were more common in already colonized patients. No risk factors were determined for patients colonized during hospitalization. As all the isolates identified were C. albicans. It appears that at present, colonization and/or infection by more resistant Candida species is not a problem in our unit.