[Candidemia in an intensive care unit].

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Mycology

Background:

• Candidemia is an increasing concern due to improved survival of critically ill patients, widespread antimicrobial use, and more invasive procedures.
• Diagnosis of candidemia is challenging, contributing to rising treatment costs and mortality rates.

Purpose of the Study:

• To evaluate the pathogens causing candidemia, identify risk factors, and assess their impact on patient outcomes.
• To analyze trends in candidemia pathogens over a four-year period in intensive care units.

Main Methods:

• Retrospective analysis of data from 41 patients with positive blood cultures for Candida species in intensive care units.
• Evaluation of patient demographics, clinical conditions, treatments, and outcomes.

Main Results:

• Candida albicans caused 48.8% of candidemia cases, while non-albicans Candida species accounted for 51.2%.
• The proportion of non-albicans Candida species as the primary cause of candidemia increased from 2004 to 2007 (from 16.7% to 47.1%).
• Mortality was high at 58.5%, with mechanical ventilation and urinary bladder catheter use being significant risk factors for lethal outcomes.

Conclusions:

• There is a notable increase in candidemia prevalence in intensive care units.
• Non-albicans Candida species are becoming more prevalent and are associated with a higher risk of mortality.
• Empirical treatment with non-azole antifungal agents is recommended for suspected invasive fungal infections in intensive care units when the specific pathogen is undetermined.