Retrospective Evaluation of Risk Factors for Invasive Candida Infections in a Medical Intensive Care Unit

Area of Science:

• Medical Mycology
• Infectious Diseases
• Critical Care Medicine

Background:

• Invasive candidiasis poses a significant threat in intensive care units (ICUs).
• Understanding risk factors and evolving fungal strain prevalence is crucial for effective management.

Purpose of the Study:

• To identify risk factors for invasive candidiasis in a medical ICU setting.
• To analyze trends in Candida species distribution and antifungal resistance.

Main Methods:

• Retrospective analysis of fungal growths from 179 ICU patients between January 2016 and December 2018.
• Recording of demographic, clinical, treatment, and outcome data.
• Identification of Candida species and assessment of fluconazole resistance.

Main Results:

• Candida albicans was the most common strain (47.9%).
• Non-albicans Candida strains, particularly Candida glabrata, showed an increasing incidence over the study period.
• Candida parapsilosis was most common in candidemia cases, associated with more severe infections.
• Older age, higher APACHE II scores, and longer ICU/hospital stays were significantly associated with fungal growth.

Conclusions:

• The rising incidence of non-albicans Candida strains in critically ill patients necessitates vigilant monitoring.
• Age, disease severity (APACHE II score), and prolonged hospitalization are key risk factors for invasive candidiasis in ICUs.