Evaluation of Candidemia Cases Developed in the Intensive Care Unit: A Ten-Year Analysis

Abstract

Objective: Fungal infections have been a major health problem for many years. They constitute a major cause of increased mortality and morbidity, especially in immunocompromised patients and intensive care unit (ICU) patients. In this study, we aimed to evaluate the epidemiologic characteristics, mortality and causative agent distribution of cases of healthcare-associated candidemia (HCA) in intensive care units of our hospital and to contribute to the literature. Methods: Our study included patients diagnosed with healthcare-associated candidemia who were hospitalized in 3rd level ICUs with various complaints between November 2011 and August 2021 in Meram State Hospital. Results: In our study, the mean age of patients who developed candida infection during intensive care unit hospitalization was 67.2±20.5 years. Of these patients, 59.5% (n:103) were men and 40.5% (n:70) women. Mean duration of hospitalization in the intensive care unit was 38.2±29.5 (min:1, max:231) days. Grouping of candida related HCAIs developed in patients according to Centers for Disease Control and Prevention (CDC) criteria shows that the most common candida related healthcare-associated infection (HCAI) was central line-associated bloodstream infection (CLABSI) at 52% and the second most common was laboratory-confirmed bloodstream infection (LCBI) at 31.2%. Cumulatively, candidemia are significantly higher to other candida related HCAIs. Conclusion: To prevent and empirically treat candidemia, which has a very high mortality rate, the causative agent distribution of the center should be well understood. Large-scale, high-quality studies using various biomarkers in addition to clinical findings for the correct antifungal selection and to reduce mortality due to invasive candidiasis in line with these selections are warranted.