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Updated: May 20, 2026
An Ex vivo Assay to Study Candida albicans Hyphal Morphogenesis in the Gastrointestinal Tract
Published on: July 1, 2020
[Epidemiological profile and sensitivity pattern of isolates causing invasive fungal infection vs. colonizing
Ricardo Serrano1, Adelina Gimeno, Lidia Plumed
1Servicio de Medicina Intensiva, Hospital General Universitario de Alicante, Alicante, España. serrano_ric@gva.es
Background:
Patients admitted to critical care units can be infected with a large number of fungal isolates that are occasionally responsible for invasive fungal infections (IFI).
Aims:
To describe the epidemiological profile and antifungal susceptibility patterns of fungal isolates in our unit, and to identify key risk factors associated with the development of IFI.
Methods:
A descriptive cohort and retrospective study with patients admitted to a polyvalent Critical Care Unit of a university hospital was carried out. The isolation of at least one fungal species in a culture of biological samples, over a period of 48 months was considered.
Results:
Twenty patients out of 232 developed IFI. Patients in the IFI group had a higher mortality and higher Candida score value 48 h prior to clinical diagnosis. Risk factors associated with the development of IFI were chronic obstructive pulmonary disease, gastrointestinal surgery, total parenteral nutrition, and prolonged systemic corticosteroid therapy. The predominant fungal species in both groups was Candida albicans, with global resistance to fluconazole and itraconazole of 1.94%.
Conclusions:
We found a low incidence of species of Candida non-C. albicans in our unit. The rate of resistance to azoles in C. albicans was similar to that of larger series. Gastrointestinal surgery, COPD, prolonged treatment with corticosteroids, and parenteral nutrition administration are risk factors associated with the development of IFI.
Insights
Invasive fungal infections (IFI) are a concern in critical care. Key risk factors include COPD, gastrointestinal surgery, and corticosteroid therapy, with low azole resistance in Candida albicans.
Area of Science:
- Critical care medicine
- Mycology
- Infectious diseases
Background:
- Critical care units (CCUs) frequently encounter fungal isolates, posing a risk for invasive fungal infections (IFI).
- Understanding the epidemiology and antifungal resistance patterns of these fungi is crucial for patient management.
Purpose of the Study:
- To characterize the epidemiological profile of fungal isolates in a university hospital's CCU.
- To determine antifungal susceptibility patterns of isolated fungi.
- To identify significant risk factors linked to the development of IFI.
Main Methods:
- A retrospective cohort study was conducted over 48 months in a polyvalent CCU.
- Data included all patients with at least one fungal species isolated from biological samples.
- Epidemiological data and antifungal susceptibility were analyzed.
Main Results:
- Twenty out of 232 CCU patients developed IFI.
- Patients with IFI exhibited higher mortality and elevated Candida scores.
- Identified risk factors for IFI included chronic obstructive pulmonary disease (COPD), gastrointestinal surgery, total parenteral nutrition, and prolonged corticosteroid use.
- Candida albicans was the predominant species, with a low azole resistance rate (1.94% for fluconazole and itraconazole).
Conclusions:
- The incidence of non-albicans Candida species was low in this CCU.
- Azole resistance rates in Candida albicans were comparable to larger studies.
- COPD, gastrointestinal surgery, prolonged corticosteroid therapy, and parenteral nutrition are significant risk factors for IFI in CCU patients.
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