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Epidemiological Characteristics and Mortality Predictors of Candidemia Due to Candida albicans: A Single-Center
Nevzat Ünal1,2, Ayşe Sultan Karakoyun3, İlker Ünal4
1Division of Mycology, Department of Microbology, Faculty of Medicine, Çukurova University, Adana 01330, Türkiye.
Abstract:
Candidemia is a major global health challenge, with Candida albicans being the most common causative agent. Since antifungal drugs may promote resistance, regular epidemiological studies are required. Nonetheless, microbiological and clinical data on C. albicans in Türkiye are limited. Therefore, we assessed data from C. albicans cases in a tertiary care hospital in Türkiye. Among 171 enrolled patients, the overall mortality rate was 66.7%. Univariate analysis showed that age, intensive care unit (ICU) admission, central venous catheterization, mechanical ventilation, hemodialysis, diabetes mellitus, Coronavirus disease 2019 (COVID-19) infection, steroid use, and hyperalimentation were associated with mortality. Multivariate logistic regression showed that age, ICU admission, steroid use and hyperalimentation were independently associated with mortality. In Cox regression, age, ICU admission, prior antifungal use, and absence of antifungal treatment after candidemia were independently associated with decreased survival. Fluconazole (FLC) was the most frequently used antifungal, and patients treated with FLC + amphotericin B or FLC + echinocandin had the best survival rates. All 171 isolates were susceptible to all tested antifungals. Our findings show high mortality rates and reveal mortality-associated factors. Candida albicans remains susceptible to all antifungals; therefore, timely diagnosis and appropriate antifungal treatment can enhance survival and clinical outcomes.