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Epidemiology, Risk Factors and Mortality of Fungal Bloodstream Infection: 14 Years of Experience at a Teaching

Júlia Pongrácz1, Tamás Szabó2, Emese Juhász2

  • 1Department of Laboratory Medicine, Semmelweis University, Budapest, Hungary. pongracz.julia@semmelweis.hu.

Mycopathologia
|June 17, 2025
PubMed

Insights

Fungal bloodstream infections (BSI) are deadly, with Candida albicans being most common. Risk factors include surgery and immunosuppression, and mortality remains high, with no acquired resistance found.

Area of Science:

  • Infectious Diseases
  • Mycology
  • Clinical Microbiology

Background:

  • Fungal bloodstream infections (BSI) are serious and often fatal.
  • Risk factors like immunosuppression, surgery, and malignancy contribute to BSI.
  • Epidemiology and patient conditions vary globally.

Purpose of the Study:

  • To analyze species distribution, antifungal susceptibility, risk factors, and mortality of fungal BSI.
  • To provide a 14-year overview of fungal BSI at a specific institute.

Main Methods:

  • Retrospective analysis of 414 fungal BSI episodes over 14 years.
  • Identification of causative fungal species and assessment of antifungal susceptibility.
  • Evaluation of patient risk factors and 30-day mortality rates.

Main Results:

  • Candida albicans (54%) and C. glabrata (16%) were the most common species.
  • Major risk factors included abdominal surgery (48.3%), solid tumors (31.4%), and immunosuppression (26.3%).
  • Overall 30-day mortality was 45.7%, with C. tropicalis BSI having the highest mortality (59.4%).

Conclusions:

  • Fungal BSI remains a significant cause of mortality, influenced by species and patient factors.
  • Abdominal surgery is a key risk factor, particularly for C. albicans and C. glabrata infections.
  • No acquired antifungal resistance was observed, but certain antifungal prophylaxis strategies may increase BSI risk.
Keywords:
Bloodstream infectionCandidaemiaEpidemiologyInvasive fungal infection

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